Results
Medical provider claim petition dismissed, with prejudice.
The parties were litigating a motion for medical treatment in which a physician was recommending an additional spinal surgery. The physician moved forward without authorization and performed spinal surgery on the petitioner. In order to complete the surgery, the physician brought in several ancillary services, including a vendor to perform diagnostic monitoring during the surgery. Following the surgery, the medical provider submitted its bills to the carrier, which were rejected based upon the lack of authorization. After a medical provider claim petition was filed, the respondent filed a motion to dismiss the matter for failure to obtain the requisite statutory authorization. The medical provider argued that it was only providing ancillary services and, therefore, did not require the authorization of the carrier under the New Jersey Workers’ Compensation Statute. The medical provider also argued that they were the “victim” since they were advised by the physician that the procedure was authorized. The judge rejected both arguments, holding that all medical providers including providers that provide ancillary services for surgical procedures, are required to obtain the same authorization for their treatment, or risk not receiving financial reimbursement.
Workers’ comp claim dismissed for lack of jurisdiction and coverage for an occupational accident policy carrier.
The petitioner filed a claim petition within the New Jersey Division of Workers’ Compensation seeking benefits and alleging employment with a trucking company. However, the petitioner had previously obtained an occupational accident policy in the role of an independent contractor. When filing the workers’ compensation petition, counsel for the petitioner erroneously named the occupational accident policy carrier as carrier for the trucking company. Although it would appear clear that jurisdiction and coverage do not exist in such cases, most times it is a lengthy process to have such matters addressed by the court and ultimately dismissed. In this case, we were successful in obtaining the dismissal and ceasing further unnecessary financial costs to the client.
Claim dismissed over alleged COVID-19 permanent disability.
Our attorneys were successful in obtaining an order for dismissal in the Mount Holly, New Jersey Workers’ Compensation court. In his claim petition, the petitioner alleged permanent disability as a result of contracting COVID-19 while working for the insured. He alleged that while working as an auto hauler he was exposed to COVID-19, which resulted in a permanent pulmonary disability. The defense argued to the judge that the petitioner’s discovery failed to provide sufficient proof and evidence supporting that the petitioner had COVID-19 or that, if he did, it was “related to his job.”
Workers’ compensation defense verdict for a prominent health care system.
The petitioner filed a motion for additional medical and temporary disability benefits, essentially alleging she was permanently and totally disabled from prior compensable shoulder and leg injuries. After a three-day trial and extensive briefing, the judge dismissed the motion. He determined that, despite the compensable injuries, the petitioner had plateaued medically and was not entitled to any further benefits.
