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Chair, Medicare Compliance Practice

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Portrait of Anthony Natale III

Results

  • Defense Verdict Obtained Involving an Employment-Related Shoulder Injury

    We received a defense verdict on a claim petition in a case where the claimant sustained a shoulder injury during the course and scope of employment. The employer brought the claimant back to work, to a light-duty driving position that caused a limited loss of wages (for about 1.5 months). They then allowed the claimant to earn his pre-injury wages. The job was so light that the claimant was found sleeping in the employer’s truck during work hours. He was discharged for cause. After the claimant secured new employment with another company at lower wages, he alleged he was entitled to ongoing partial disability. The subsequent claim petition turned on the facts surrounding the discharge as being the real cause for the disability. The business record exception to the hearsay rule was dissected by the court, and the claim petition was dismissed based on the employer’s legally admissible fact and medical witness testimony.

    man with sling signing contract photo
  • Defense Verdict Secured in a Case Centered on an Employment-Related Low Back Injury

    We received a defense verdict on our termination petition in a case where the claimant sustained a low back injury when he slipped and fell in an elevator during his employment. The employer had an IME wherein the claimant was pronounced fully recovered from strain injuries. The claimant presented evidence that alleged disc injury and ongoing radiculopathy. The matter proceeded to litigation and a decision on the merits. The court found the employer’s expert to be credible as to full recovery based on the finding that no architectural change could be identified between the claimant’s diagnostic studies when compared to studies from before and after the work injury.

  • Defense Verdict Secured in a Workers’ Compensation Penalty Petition

    We won a defense verdict on a penalty petition filed by the claimant against a mushroom company. In the penalty petition, the claimant alleged that Supreme Court precedent allows the finding of a penalty when a carrier does not immediately issue an award check after a decision on the merits. The check was issued 19 days after the decision (and within the 30-day time period commonly accepted in the business for payment of awards). The claimant argued that payment should have been made within one day of the award. The case turned on legal precedent concerning the efficacy of statements made in dicta versus common sense practice. The case held implications for procedure on payments of awards in Pennsylvania. After hearing oral argument, the court held that the employer’s argument was more logical and supported by the preponderance of the case law. 

  • Defense Verdict Won in a Workers’ Compensation Claim Petition

    We won a defense verdict on a claim petition filed by the claimant, a police officer for the township. The claimant was called to the scene of an active shooter barricaded in his home. The officer was placed in a strategic position outside the home with weapon drawn. The standoff lasted many hours, but was resolved peacefully when SWAT arrived. The claimant finished his shift and went home. The next morning he awoke with headaches, nausea, double vision and dizziness. Ultimately, he was diagnosed with mini-stroke, nerve palsy and resultant diplopia—he was disabled from working. He filed a claim petition and presented a neurologist to support a work injury. This doctor’s deposition was riddled with objections since the neurologist tried to read into the record (and at times misread into the record) the diagnoses of a neuro-ophthalmologist. The neurologist then tried to argue that the claimant’s condition was a psychological injury in origin. The employer presented the opinions of a board certified neuro-ophthalmologist, who opined that the claimant has no work-related injury. The court found the employer’s evidence to be more believable, and the claim petition was dismissed.

  • Successfully Affirmed Workers’ Compensation Decision Before the Appeal Board

    We convinced the Commonwealth Court to affirm the decision of the Workers’ Compensation Appeal Board in favor of our client, the employer, which upheld the workers’ compensation judge’s denial of a claim petition. By memorandum opinion, the court found that the judge’s credibility findings were neither contradictory nor arbitrary and capricious, and the decision was reasoned. The court agreed with the employer that the defense experts’ opinions constituted substantial evidence, also noting that the Social Security Administration’s findings of disability were irrelevant to the issue of work-relatedness. The court concluded that the claimant failed to sustain her burden of proving a work-related injury, and since the causal connection between her “lingering symptoms and her work duties” was not obvious, she was required to present unequivocal medical evidence establishing that connection, which she failed to do.

  • Successfully Defended a Pennsylvania Township in a Fatal Claim Petition

    We successfully defended a township in Bucks County in the litigation of a fatal claim petition. The widow made an allegation that the decedent (a police K-9 officer) died in his home as a result of exercising with his police dog before heading to work. The fatal claim petition alleged that the decedent died of hypertrophic cardiomyopathy brought on by “vigorous exercise.” The widow presented an expert who held himself out to be a cardiologist. We established during voir dire examination that the expert had no Board Certification in cardiology. We also forced the expert to admit that cardiomyopathy was a pre-existing condition that, in a vast majority of cases, causes death without exertional activity. The widow testified in the matter, but on cross examination she could not confirm the decedent’s exercise because she was asleep at the time. The widow presented a detective and a police chief who asserted that the decedent was in the course and scope of employment at or near the time of death, but both witnesses on cross examination were not present on the morning of the decedent’s death and could not verify that the decedent was undertaking exertional activities. We presented a Board Certified cardiologist who testified that cardiomyopathy is a hereditary condition and not caused or aggravated by activities. The decedent’s death was, therefore, characterized as death by natural causes. The court delivered a full defense verdict in dismissing the fatal claim in its entirety.

  • Successfully Defended Claim Petition for a Major Manufacturing Supplier

    We successfully defended a claim petition on behalf of one of the world’s leading suppliers of equipment and services to packaging and label manufacturers. The claimant was helping to lift a 400-pound slab when she felt her shoulder “pop.” She continued to work for several months, allegedly in pain, until she could no longer work. After vigorous cross examination, the claimant was forced to admit that she provided notice 122 days after the date of injury—which is untimely by the letter of the law. The claimant then asserted that her injury was “repetitive trauma,” arguing that each day she worked after the original incident caused a new injury. Both parties presented medical experts. Cross examination of the claimant’s medical expert dispelled the claimant’s theory of compensability. The court required that the parties engage in mandatory mediation. The claimant declined, noting that “she wanted her day in court,” and then changed attorneys. The court dismissed the claim petition on the bases of violation of notice provisions of the Act and on the lack of credibility of the medical expert presented.

  • Successfully Defended Claim Petition for Philadelphia-based University

    We successfully defended a claim petition on behalf of a Philadelphia-based university. While working for the university as a janitor, the claimant slipped and fell down a flight of concrete stairs. He alleged multiple body part injuries, from head to toe. The employer’s panel doctor did find work injuries limited to the claimant’s extremities. The claimant was referred by his attorney to a pain specialist, who opined significant injuries to multiple body parts. However, during the expert’s trial deposition, he was forced to admit that he has been practicing medicine for less than two years and only offered opinions about neck and back injuries—nothing else. The claimant alleged serious disc herniation injuries in the neck and back, and pursued other body part injuries in the litigation, with no additional expert evidence. The employer presented an orthopedic surgeon who found no injuries on the date of his evaluation and opined that the claimant fully healed from any injuries he may have sustained. The court found only minor strains to the neck and back with a full and complete recovery (and no further benefits due).

  • Defense Verdict in Medicare Lien Dispute for Insurance Carrier

    We successfully defended a Massachusetts-based insurance company in a bitter dispute with the federal government regarding a Medicare conditional lien request. The insurance carrier’s satellite office is based out of New Jersey, and the underlying claim involved an injury sustained in a motor vehicle accident with payments being made to the claimant under a New Jersey PIP policy. The carrier exhausted the PIP policy following the injury. Medicare also paid significant medical bills for the claimant and demanded through the Center for Medicare and Medicaid Services (CMS) that the carrier reimburse all payments made as a conditional lien request. CMS, through their many contractors, threatened legal action with double damages if the lien was not satisfied. The carrier appealed the lien request through two levels of CMS contactors with no success. We formulated a third-level appeal to an administrative law judge, arguing that CMS’s request for additional liens violated state PIP policy law and the carrier’s constitutional rights. Evidence presented showed the PIP policy had been exhausted and, thus, the carrier reverted back to a secondary payer, forcing Medicare/CMS as the primary payer under federal law. The court agreed and a full defense verdict was issued.   

  • Defense Verdict Secured for a Montgomery County Police Department

    We successfully defended a Montgomery County police department in the litigation of a claim petition. The claimant, a police officer, attended an out-of-state extended-stay educational conference. One evening after the conference activities ended, the claimant attended a “booze cruise” where she was imbibing with conference attendees. She continued to socialize and party back at the hotel. Later that night, she entered her hotel suite (which was shared with another female officer), shining her flashlight in order to change clothes. While changing, her roommate became perturbed over the ruckus. An argument between the two officers ignited and soon turned into full-fledged fisticuffs. The pugilists both were injured in the brawl. The claimant filed a claim petition, alleging physical injuries, post-concussive syndrome, mental injuries and total disability. We cross examined the claimant and developed an evidence record that supported she was not in the course and scope of employment at the time of injury. We presented medical witnesses to support that the claimant did not suffer from post-concussive syndrome or any disabling physical or mental injuries. The court found the claimant was not in the course and scope of employment, and the claim was barred by the personal animus defense.  

  • Won Defense Verdict in Landmark Workers’ Comp Case

    We secured a complete defense verdict in a first-of-its-kind workers’ compensation case, where the court concluded for the first time in Pennsylvania that carpal tunnel syndrome and cubital tunnel syndrome is not borne out through alleged repetitive trauma.  In a case of first impression in Pennsylvania, we successfully defended a Berks County mushroom canning facility from a claim petition alleging repetitive trauma injuries to the upper extremities. The claimant alleged that over time his duties as a machine operator caused nerve injuries to both upper extremities. We presented medical expert testimony supporting the existence of these nerve damage but challenged causation. In a modified Frye challenge to claimant’s medical expert opinions, we argued through expert testimony that the state of science and medicine overwhelmingly supports the fact that “repetitive trauma” is not a substantial contributing factor to the development of carpal tunnel and cubital tunnel syndromes. While the court allowed the claimant to present expert testimony to the contrary, it ultimately found our expert testimony opinions to outweigh the claimant’s expert testimony. The court concluded for the first time in Pennsylvania that carpal tunnel syndrome and cubital tunnel syndrome is not borne out through alleged repetitive trauma. This was a complete defense verdict.   

  • Successfully Defended Our Client in Litigation Surrounding a Penalty Petition

    We successfully defended a Philadelphia-based university in litigation surrounding a penalty petition filed by the claimant. The penalty alleged that the university unilaterally suspended indemnity benefits on an open and accepted work injury claim. We presented complex evidence from the insurer that Pennsylvania’s Workers' Compensation Automation and Integration System (WCAIS) electronic system has internal problems which result in unwanted and unrequested claim documents being issued when simple data changes are made to an open claim. We were able to prove that the carrier properly suspended the claim in the system and any and all updated “acceptance” documents filed by the WCAIS system were on the basis of a faulty data system. The penalty petition was dismissed in its entirety.

  • Successfully Defended an Appeal Before the Pennsylvania Workers’ Compensation Appeal Board

    We successfully defended a Pennsylvania-based industrial linear actuator supplier on appeal before the Workers’ Compensation Appeal Board. The claimant appealed a termination order which found her to be fully recovered from work injuries to her low back and multiple other body parts. The claimant alleged on appeal that factors considered by the underlying workers’ compensation judge supporting the full recovery opinion (including a post-injury new slip and fall) were not supported by the evidence record. To the contrary, we successfully argued on appeal that the workers’ compensation judge’s decision was based on cross examination of the claimant’s own medical expert wherein he gleaned a history from the claimant of subsequent injuries that were never disputed by the claimant in follow-up testimony. The Appeal Board held that the judge can only decide cases based on evidence before the court, and the Board would not overturn the judge based on new allegations of the claimant.

  • Successfully Defended a Nationwide Tight-Tolerance Manufacturer

    We successfully defended a manufacturer serving OEMs in the aerospace, defense, semiconductor and high-tech industries. The case involved a claim petition with complex injury allegations and a potentially catastrophic initial judgement on the pleadings since the employer failed to timely answer the claim petition. When we became involved, we were able to limit the judgement on the pleadings to the date that a timely answer could have been filed. Ongoing disability in the case turned on the credibility of the claimant’s medical evidence. The claimant presented an expert witness who opined that the claimant’s virtual lifetime of serious low back and neck abnormalities were “aggravated” by his having sat down at work after feeling dizzy. Tony presented rebuttal expert evidence from a well-respected orthopedic surgeon demonstrating no architectural change in the claimant’s lumbar spine or cervical spine due to the alleged injury event and no ongoing or acute problems. The court accepted the defense evidence as credible, and the claimant was found to be without ongoing disability and fully recovered from any condition subject to the former judgement on the pleadings.

  • Claimant’s Appeal Successfully Defeated in Motor Vehicle Accident Case

    We successfully defeated the claimant’s appeal on a hotly-debated issue surrounding course and scope of employment in a case involving a motor vehicle accident during a paid lunch hour, which resulted in extreme medical treatment costs. We were able to convince the underlying court that the claimant was not in the course and scope of employment at the time of injury due to her deviation to run personal errands. The claimant appealed alleging the fact that, as her lunch hour is paid, she was certainly in the course and scope of employment and the underlying court erred. The Appeal Board affirmed the underlying court’s judgment, and claimant’s appeal was dismissed.

  • Termination petition successfully prosecuted.

    We successfully prosecuted a termination petition, securing a full recovery opinion from the court with reference to a Medicare eligible claimant who worked for a local Philadelphia financial institution. The claimant suffered a knee injury during the course and scope of employment. She ultimately required knee surgery for a torn meniscus. We presented evidence from the claimant’s treating surgeon, coupled with an independent expert, to produce an evidence record that demonstrated by preponderance of the evidence that the knee injury had fully resolved.

  • Fake COVID-19 test sinks plaintiff’s case

    We successfully prosecuted a suspension petition in a case of first impression in Pennsylvania. The claimant sustained a compensable mental injury while employed with the employer. Thereafter, he refused to attend an Impairment Evaluation after receiving 104 weeks of indemnity benefits due to his injury. The court initially issued an order compelling the claimant’s attendance. Nevertheless, the claimant maintained his refusal to attend the evaluation, citing the fact that he was COVID-19 positive and required to quarantine. We demanded that verification of the virus be made part of the evidence record. In response, the claimant’s attorney submitted into the evidence record a COVID-19 testing result, which was an at-home test. We reviewed the testing result and found that it was a fake—there was a pornographic image contained in the window of the positive testing result, and through internet research we determined that this fake test was being used all over the United States. The claimant’s attorney was unaware that the test was fake and maintained it as part of the evidence record. At oral argument, Tony referred the court to the manufactured evidence and not only argued for a suspension of benefits, but also alleged that the claimant violated the fraud provisions of the Pennsylvania Workers’ Compensation Act. Claimant’s attorney immediately removed himself as counsel of record. The court determined, based on the evidence, that benefits were suspended and actually concluded as a matter of law that the claimant committed fraud – a decision of first impression in Pennsylvania.   

  • Fatal claim petition against national trucking company denied.

    The decedent died of a heart attack after a three-day, over-the-road run for the trucking company. The decedent’s dependents argued that the heart attack was caused by the rigors of the job. Although the decedent died as he was about to execute paperwork denoting his employment status as an independent contractor—he never signed the document. The case, therefore, proceeded to litigation in the Workers’ Compensation forum. Expert evidence was presented on the issue of whether the decedent’s job duties had any contribution to the death. The court concluded, based on the evidence presented, that the work duties had no relationship whatsoever to the demise of the decedent. The fatal claim was dismissed in its entirety.

  • Injuries at mushroom facility found non-work related.

    We successfully prosecuted a termination petition and at the same time defended a review petition on behalf of a Berks County mushroom facility in a falling object case. The claimant sustained a strain injury to his neck when he was struck by a stack of falling mushroom baskets at work. Although the baskets only grazed one side of his head and neck, the claimant alleged that his opposite shoulder was injured in the accident to the extent of a fully torn rotator cuff tendon. The claimant also alleged that a calcified longitudinal ligament in his neck was also caused by this accident, resulting in surgery and disability. We convinced the court that the only injury sustained during the incident was a neck strain that fully recovered—all other alleged injuries were found not to be work related.

  • Judge agrees that claimant was not on a “special mission.”

    We defended a claim petition and penalty petition wherein the claimant alleged serious neck and back injuries as a result of a work-related motor vehicle accident. We convinced the judge that the claimant was not in the course and scope of employment at the time of injury and, therefore, his claim was barred. The judge noted that, based on claimant’s testimony on cross examination, he had a legal address in North Carolina but was allegedly leasing an apartment in Newtown Square, Pa. He alleged he was on a special mission on the date of injury, traveling to an office owned by the employer. It was established that on the date of the accident, he was traveling on an expressway in New Jersey prior to his shift and admitted that his job required him to service many of the employer’s offices. The judge accepted the defense argument that the claimant was traveling to work, not in the course and scope of employment and not on a special mission, and dismissed the claim and penalty petitions.

  • Successful Prosecution of a Termination Petition

    We successfully prosecuted a termination petition on behalf of a Philadelphia-based ice cream shop. The claimant sustained a serious ankle fracture after a slip and fall in the shop’s freezer. We utilized the treating physician to certify the claimant’s full and complete recovery from the ankle fracture and established that there were no residual maladies or disability stemming from the incident.

  • Claimant fails at attempt to use COVID-19 pandemic to support payments of disability.

    We successfully defended a regional energy efficiency service agency in a claim petition wherein the claimant attempted to use the COVID-19 pandemic to support payments of disability. The claimant alleged that a work-related auto accident disabled him from employment at the time he was subject to an economic lay-off due to the pandemic. The defense convinced the court that at the time of layoff the claimant was capable of performing his pre-injury job duties despite alleged restrictions due to the motor vehicle accident. The judge also found the claimant to have made a full and complete recovery from the work injury during the pandemic lay-off, and the claimant demonstrated no good reason for his failure to return to work once the pandemic restrictions dissipated. The claim petition was denied and dismissed.

  • Judge rules against Berks County mushroom worker.

    In a case of relative first impression in Pennsylvania, we successfully defended a mushroom harvesting company. The claimant sustained a work-related injury to the right shoulder. She underwent surgery and was released to modified duty. The employer offered her a modified job. The claimant returned to work and continued at restricted duty. She was ultimately found to be fully recovered by a renowned Philadelphia shoulder surgeon. The defense then filed a termination petition, alleging full recovery of the right shoulder. The claimant responded by filing a claim petition, alleging a new injury to the opposite shoulder that totally disabled her from employment. After cross examining the claimant, it was determined that she purposely exceeded her work release restrictions upon return to work, despite the employer’s directive to the contrary. The claimant alleged that her voluntary acts exceeding her restrictions caused her new injury. The judge ruled that the claimant was not in the course and scope of employment when she exceeded her restrictions, and that the alleged injuries to her left shoulder were degenerative, not work-related. The judge also found the claimant to be fully recovered from the previously accepted right shoulder injury.

  • Successful defense of turkey farm against a $1 Million amputation claim.

    We successfully defended one of Pennsylvania’s largest turkey processing plants in a million dollar amputation claim. The claimant alleged that, due to an alleged exposure to turkey blood and feces at the workplace, he developed an infection in his foot that led to amputation of his leg. The claimant alleged a specific loss of the leg, total disability due to injuries separate and apart from the loss, and disabling psychological injuries. The defense was able to prove through the use of an infectious disease expert that the claimant’s leg amputation was caused by an underlying venous insufficiency and infection stemming from years of uncontrolled diabetes. The defense also established on cross examination that the claimant failed to provide proper notice of a work-related injury within the meaning of the Workers’ Compensation Act. 

  • Employer and insurer dismissed from COVID-19 litigation.

    We were successful in dismissing the employer and insurer from a fatal claim as a result of COVID-19 infection. The claimant-widower filed the claim on behalf of his deceased wife, alleging she contracted COVID-19 while working in the capacity of a caretaker for a sick client. We argued that the correct employer for workers’ compensation purposes was the claimant’s client, not the named employer. The Workers’ Compensation Judge agreed and dismissed the named employer and insurer as party defendants.

  • Successful prosecution of de novo request for hearing.

    The hearing was to challenge the Pennsylvania Bureau of Workers’ Compensation Fee Review Section’s final determination that an injured worker’s shoulder surgery expenses must be paid by the insurance carrier and the employer. We argued that the work-relatedness of the shoulder surgery is currently in dispute, thus barring the Bureau’s attempt to compel payment. We also proffered the argument that due process of the provider remained intact since a challenge to work-relatedness must be adjudicated before a provider has standing to challenge the amount or timeliness of payment. The decision of the court quashed the Bureau’s determination and held that no surgical expenses are payable.

  • Successful defense of large Philadelphia-based law firm in litigation of claim petition alleging post-concussion syndrome.

    The claimant slipped and fell at work, injuring his head and neck. The carrier accepted a contusion injury. The claimant alleged multiple additional injuries including cognitive maladies, memory loss, speech problems, vision convergence, photophobia, cranial nerve injuries and balance issues. The claimant testified while wearing sunglasses due to his alleged photophobia condition. Thirteen hours of surveillance video disputed the claimant’s alleged symptoms (including his need for sunglasses). Prior health records revealed the claimant to be treating for all of his alleged cognitive problems before the work incident ever took place. The claimant’s first treating neurologist records supported the claimant’s symptoms to be non-anatomical. The carrier’s IME physician found the claimant to have suffered non-disabling contusion injuries which resolved. The judge found in favor of the employer and carrier, ruling that the claimant’s injuries were limited to contusions and had fully resolved. The claimant appealed the case to the Workers’ Compensation Appeal Board, arguing the judge capriciously disregarded the evidence. The Board held that the claimant’s appeal was a veiled collateral attack on the workers’ compensation judge’s credibility determinations and affirmed the judge. At issue were potential life-time indemnity benefit payments and over $1 million of medical expenses.

  • Post-concussion syndrome workers’ compensation claim dismissed.

    We successfully defended a machine shop in the litigation of a claim petition involving post-concussion syndrome. The claimant was struck in the head with a wrench while repairing a machine for the employer. The carrier accepted a head laceration by way of medical only notice of compensation payable. The claimant was treated for a laceration to the side of his head and released to return to work. Several months later, he was taken out of work by his treating neurologist for symptoms allegedly related to post concussive syndrome. The claimant then returned to modified duties within new work release restrictions. He abandoned that job several weeks later, alleging he was totally disabled due to post concussive syndrome. We presented surveillance evidence demonstrating the claimant’s ability to perform all activities of daily living. A nationally renowned neurologist testified that, while the claimant suffered a mild concussion at the time of injury, he did not suffer from post concussive syndrome and was fully recovered. The claimant’s co-workers testified that they observed the claimant after the injury, and the claimant was able to continue working with no signs of post concussive problems. We cross examined the claimant, and it was discovered that he was performing work duties on his own in the carpentry field, despite alleging he was totally disabled. The workers’ compensation judge opined that the claimant’s injuries were limited to the head laceration and mild concussion, and then concluded that those injuries had fully recovered. The claimant was due no additional workers’ compensation benefits other than what he had already received. The claim petition for disability was dismissed.

  • Successful defense of law firm in workers’ comp case.

    We successfully defended a Philadelphia-based law firm in litigation surrounding an alleged work injury with resultant post-concussion syndrome. ​The claimant tripped and fell at work, alleging that he struck his head during the fall. He donned sunglasses at the hearing and depositions, claiming his injury led to photophobia and post-concussion syndrome. During discovery, it was determined that the claimant had suffered and was treated for headache symptoms and memory loss prior to the alleged work injury. Surveillance revealed that the claimant did not use sunglasses when carrying out everyday activities. The claimant's medical expert admitted on cross-examination that he was unaware of the claimant's pre-existing medical condition and was not aware of the surveillance evidence when arriving at his opinions and conclusions. The workers’ compensation judge found that the claimant and the medical expert were not credible, leading to the successful resolution of the claim.

  • Successful Defense of High Exposure Appeal.

    We successfully defended a Northeastern Pennsylvania manufacturing and supply company in an appeal involving high medical and indemnity exposure. ​The claimant suffered a shoulder strain while lifting at work. She returned to the job only to allege a recurrence of her shoulder disability shortly thereafter. She filed a reinstatement petition that was denied when the Workers’ Compensation Judge accepted our argument that the recurrence was due to a non-work-related motor vehicle accident. Thereafter, the claimant traveled to Florida and underwent cervical disc surgery. Nearly a year after the surgery, she filed a petition, alleging that the cervical disc herniation was caused by the original work injury and the neck surgery and resultant disability were work related. The judge found the cervical disc herniation was not caused, aggravated, accelerated or worsened by the work injury and the surgery was not payable. The claimant then filed an appeal to the Workers' Compensation Appeal Board, arguing that the judge disregarded substantial evidence of causation. The Board heard oral argument and ruled that the judge's ruling is free of error.

Firm Highlights

Thought Leadership

NJ Workers' Compensation Legislation Update

A couple more bills were introduced for the 2026-27 session. Any updates since February have been highlighted in bold. A1023 | S3984 Medical use of cannabis under certain circumstances This requires workers’ compensation, PIP, and health insurance coverage for the medical use of cannabis under certain circumstances. It was introduced on January 13, 2026 and referred to the Assembly Financial Institutions and Insurance Committee. It was also introduced on March 19, 2026 and referred to the Senate Commerce Committee. A1045 Certain injuries to volunteer and professional public safety and law enforcement personnel This revises workers’ compensation coverage for certain injuries to volunteer and professional public safety and law enforcement personnel. It was introduced on January 13, 2026 and referred to the Assembly Labor Committee. A3724 Personal liability to employer officers for failure to pay for coverage This provides personal liability for owner, executive officer, or executive director of employer for failure to pay for workers' compensation coverage. It was introduced on January 13, 2026 and referred to the Assembly Labor Committee. On May 7, 2026, it was reported and referred to Assembly Judiciary Committee. A4617 Certain workers' compensation supplemental benefits and funding method This concerns certain workers' compensation supplemental benefits and funding method. For a permanently and totally disabled worker or surviving dependents after December 31, 1979, with some exceptions, this bill provides for an annual cost of living adjustment in the weekly workers’ compensation benefit rate. It was introduced on March 10, 2026, and referred to the Assembly Labor Committee. S241 Inclusion in database of appointed officials This requires that workers’ compensation judges and administrative law judges be included in database of appointed officials. It was introduced on January 13, 2026 to the Senate, Referred to Senate State Government, Wagering, Tourism & Historic Preservation Committee. A1870 | S1379 Workers' compensation benefits for certain workers due to September 11, 2001, terrorist attacks This provides workers’ compensation benefits for certain public safety workers who developed illness or injury as result of responding to September 11, 2001 terrorist attacks. It was introduced on January 13, 2026 and referred to the Assembly Labor Committee. It was also introduced on the same day and referred to the Senate Labor Committee. On February 5, 2026, it was reported from the Senate Committee, 2nd Reading, and referred to the Senate Budget and Appropriations Committee. A2779 | S1521 Excludes Certain Illegal Aliens This excludes certain illegal aliens from workers’ compensation and temporary disability benefits. It was introduced on January 13, 2026 and referred to the Senate Labor Committee. It was also introduced on the same day and referred to the Assembly Labor Committee. A2792 | S1555 Prevent Intoxicated Employees from Workers’ Compensation This prevents intoxicated employees from receiving workers’ compensation. It was introduced on January 13, 2026 and referred to the Senate Labor Committee. It was also introduced on the same day and referred to the Assembly Labor Committee. S2290 Increase Mandatory Retirement Age This increases statutory mandatory retirement age for Supreme Court Justices, Superior Court Judges, Tax Court Judges, Administrative Law Judges, and Workers’ Compensation Judges from 70 to 72. It was introduced on January 13, 2026, and referred to the Senate Judiciary Committee. A3167 | S2372 Workers’ compensation insurance requirements for certain corporations and partnerships. This concerns workers’ compensation insurance requirements for certain corporations and partnerships. It was introduced on January 13, 2026 and referred to the Senate Labor Committee. It was also introduced on the same day and referred to the Assembly Labor Committee. A1384 | S2757 Reduce Statute of Limitations in Medical Fee Disputes This reduces statute of limitations from six years to two years in medical fee disputes in workers’ compensation matters. It was introduced on January 13, 2026 and referred to the Senate Labor Committee. It was also introduced on the same day and referred to the Assembly Labor Committee. S3144 Testimony in Workers’ Compensation This concerns submission of testimony in workers’ compensation claims. It was introduced on January 13, 2026, and referred to the Senate Labor Committee. S3342 Increase Mandatory Retirement Age This increases statutory mandatory retirement age for Supreme Court Justices, Superior Court Judges, Tax Court Judges, Administrative Law Judges, and Workers’ Compensation Judges from 70 to 75. It was introduced on February 5, 2026, and referred to the Senate Judiciary Committee. A3548 | S3571 Maximum benefits for certain volunteers This provides certain volunteer and other workers with maximum compensation benefit for workers' compensation claim regardless of outside employment.. It was introduced on January 13, 2026 and referred to the Senate Labor Committee. On March 2, 2026, it was reported from the Senate Committee, 2nd Reading, and referred to the Senate Budget and Appropriations Committee. It was also introduced on the same day and referred to the Assembly Labor Committee. On May 7, 2026, it was reported and referred to Assembly State and Local Government Committee.

Result

No-Cause Jury Verdict Secured in Wrongful Death Trial

We successfully obtained a no-cause jury verdict in a 13-day wrongful death trial. The decedent, a 59-year-old man, was admitted to the emergency room on February 15, 2019, with complaints of abdominal pain, decreased appetite, and constipation, despite the use of laxatives. The patient did not complain of any nausea, vomiting, or diarrhea. He had a significant medical history including diabetes, hypertension, prior coronary artery stenting, morbid obesity (with past gastric bypass surgery), longstanding ventral hernia, and back pain. A CT scan revealed multiple hernias and a potential closed-loop bowel obstruction, leading to a surgery consultation. Our client, an emergency general surgeon, interpreted that the patient did not have a closed loop or any significant obstruction and recommended non-surgical management. The patient was approved to have clear liquids, and had a vomiting incident shortly after, but our client was not notified. The patient was returned to NPO status, and after improving overnight, he was returned to “clears” and additional medical and renal consults were ordered. Our client did not receive any communications from the residents/nurses of any changes in the patient’s condition. On February 18, 2019, two rapid responses were called due to increased heart rate and vomiting. It is believed that the vomiting resulted in aspiration, causing sepsis, ultimately leading to the patient’s death. During the trial, the plaintiff’s sole medical expert highlighted imaging on the wrong hernia, which called into question all of his opinions in the case. We made key objections related to the expert testimony, limiting what the allegations were, and preventing new allegations from being made. After approximately two and a half hours of deliberating, the jury returned a no-cause verdict. 

Thought Leadership

What’s Hot in Workers’ Comp - News and Results*

RESULTS* Ben Durstein (Wilmington) obtained a favorable decision involving a claimant who fractured his patella in a work accident requiring two surgeries. The IAB rejected the claimant’s medical expert’s opinion that he sustained a 25% permanent impairment to the right lower extremity. Instead, the board accepted the opinion of the employer’s medical expert that the appropriate permanency was 13% utilizing the 6th Edition of the AMA Guides to the Evaluation of Permanent Impairment. Tony Natale III (King of Prussia) successfully had a claim petition alleging new injuries and periods of disability dismissed based on full recovery. The claimant was injured when his skid loader was struck by another loader in the process of baling hay. Original injuries were accepted and the claimant returned to work. Thereafter, the claimant abandoned work and filed a claim petition to assert new injuries and extended disability. Cross examination of the claimant’s medical expert stunningly revealed his failure to review claimant testimony, his lack of awareness of a social security disability decision detailing the existence of claimant’s alleged work-related conditions prior to the date of work injury, and his failure to understand that the claimant admitted to full recovery of injuries for which he was continuing to treat. Tony Natale III (King of Prussia) successfully obtained a defense verdict in a Medicare conditional payment lien third level appeal. The United States government alleged a Medicare conditional lien payment was due and owing in the upper six-figure range based on an auto accident and PIP policy for which the government conditionally became the primary carrier. The government argued that our client, the PIP carrier, was the primary payer and, under federal law, must reimburse the government for its conditional lien payment. At the third-level appeal hearing, the government’s position was refuted by the revelation that the date of injury tied to the medical bills associated with the lien was glaringly and chronologically prior to the insurer’s PIP policy date. The court held that based on this evidence and argument, the government could not meet its requirements to assert a lien against our client. A. Judd Woytek (King of Prussia) and John Abda (Scranton) successfully had a workers’ compensation claim petition granted for medical benefits only for a closed period with no wage loss awarded. The claimant alleged multiple injuries as the result of a very minor motor vehicle incident where a co-worker’s delivery van rolled down an incline of approximately six feet, and bumped into the rear of the claimant’s delivery van. He claimed he was thrown forward and suffered head and neck injuries, along with aggravating a pre-existing ankle injury. The claimant was also terminated following the accident for having a large hunting knife in his van, which was against the employer’s workplace violence policy. The judge granted the claim for a mild concussion and an ankle contusion, but terminated medical benefits as of the date of our IME’s. The judge found that no wage loss benefits were payable as the claimant was terminated for cause and work remained available to him. The judge found our medical experts to be more credible than the claimant’s, along with finding our four employer witnesses to all be credible. The trial team was assisted by paralegal Bonnie Zemek (King of Prussia). Eric Scott Thompson (Wilmington) was successful in a workers’ compensation matter in Delaware. On October 15, 2024, the claimant was injured while performing fire training in a multistory building when he tripped over a fire line, injuring his right knee. The claimant received regular and consistent treatment for the right knee through August 29, 2025, when he presented with left knee complaints for the first time. His treating orthopedist diagnosed a hamstring strain. The claimant was next seen October 15, 2025, with continued left knee complaints, and was referred to a total knee doctor within the practice. He was then diagnosed with a posterior root tear of the medial meniscus. Our expert testified that it was not plausible for a lateral hamstring strain to progress to a meniscal tear in two months. The claimant required a total knee replacement that was ultimately performed in February 2026. In the six months between the time of initial presentation with left knee complaints and the total knee replacement, conservative care consisted of a single injection. Our expert testified that posterior root media meniscal tears can respond to conservative care, and it was not known if it would with the claimant because it was not adequately explored. The Industrial Accident Board agreed with our expert and determined that the claimant failed to meet the burden of establishing more likely than not that the left knee complaints were caused by overloading/overuse as a result of the compensable injury to the right knee. They also agreed that the claimant was able to return to work in a sedentary capacity as opined by his physicians and our expert prior to the left total knee replacement and that there were employment opportunities available within his restrictions and capabilities as presented by the vocational expert. As a result, the claimant was no longer entitled to total disability benefits and will receive partial disability benefits for which he is limited to 300 weeks. Michele Punturi (Philadelphia) and Alana Staniszewski (Pittsburgh) had a termination petition granted in a Pennsylvania workers’ compensation case. The petition involved an echocardiography technologist with long-term employment at a local hospital who sustained a right shoulder injury resulting in surgery in January 2024. Following surgery, the claimant was diagnosed with a frozen shoulder and underwent additional surgery in June 2024, with a recommendation for a third surgery. The opinions of the defense medical expert, a Board-certified orthopedic surgeon, were found credible, persuasive, and competent based upon the extensive history he obtained from the claimant, analysis of the mechanism of injury, and review of records, along with comparison of MRIs from October 2023, February 11, 2024, and January 6, 2025, which failed to reveal any causal relationship other than a strain/sprain of the right shoulder. This evidence supported that the claimant had fully recovered, and was not in need of any ongoing medical treatment and/or restrictions. In particular, despite allegations of injuries beyond a sprain/strain, the defense medical expert identified that those allegations were not consistent with what was found at the time of surgery, and elements of the surgery were to treat a chronic and degenerative condition. Additionally there were no ongoing issues or problems with the subscapularis, which was intact, consistent with the follow-up MRI of February 11, 2024, and the claimant did not have evidence of a frozen shoulder. In fact, the MRIs and mechanism of injury, he opined, did not support any injury causing tendonitis or inflammatory conditions within the bicep tendon. Furthermore, multiple days of surveillance footage demonstrated the claimant’s normal use, with the ability to sweep and shovel snow, operate her vehicle, raise her arms above shoulder level, and use a broom – all without any observable difficulty, which challenged the claimant’s credibility of a disability and further established a lack of causation. As a result of this favorable decision, supersedeas fund reimbursement will be obtained for both wage loss and medical benefits through the supersedeas fund recovery process. *Prior Results Do Not Guarantee a Similar Outcome NEWS Heather Carbone (Jacksonville) was a panelist for a webinar hosted by The Workers’ Compensation Claims Professionals (WCCP) Association. As part of the “Meet the Experts” Series, the speakers addressed “Afterthoughts that Undermine a Successful Mediation,” highlighting the pitfalls and challenges of underprepared or unprepared mediation participants. The discussion included appropriate pre-mediation communications, setting of expectations, management of expectations, and working through the unexpected or unprepared. Attendees gained ideas about how and when to prepare, best practices, and the potential for non-parties (spouse, significant other, risk owners-insurers) to have differing perspectives or concerns than the actual employee and employer. On May 21-22, 2026, A. Judd Woytek, (King of Prussia) joined a panel at the CLM Alliance (Claims and Litigation Management Alliance) Work Comp Conference in Nashville to present "We See You: How Employee Engagement Enhances Work Comp Outcomes." Judd and his fellow panelists discussed the positive impact of employee engagement on claim outcomes, return-to-work timelines, and overall claim costs.