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Defense Digest

Celebrating 30 Years of the Defense Digest: A Look at the Last 30 Years in New Jersey Workers’ Compensation

Defense Digest, Vol. 30, No. 4, December 2024

December 1, 2024

by Angela Y. DeMary

Key Points: 

  • The term “palliative” is not decisive as to liability to provide treatment.
  • When addressing requests for temporary total disability benefits from former employees, investigate entitlement beyond a doctor’s note changing work status. 
  • There are exclusions to the general principle that injuries during volunteering activities are not compensable.

Thinking back to 1994—30 years ago—many of us may not recall where we were or what we were doing. In fact, many readers may not have even been born at the time. However, the celebration of 30 years of Marshall Dennehey’s publication of Defense Digest provides a good opportunity to review a few significant New Jersey workers’ compensation judicial decisions from the last three decades that still impact claims handling today. This article will focus on one decision from each decade. 

1994–2004

The first decade, 1994–2004, brought the world such noteworthy events as the debut of the television show “Friends” (1994), the election of Nelson Mandela as President of South Africa (1994), and the unforgettable events of September 11, 2001. The decade also brought a notable New Jersey Appellate Division decision that still raises issues for practitioners today. 

In 1995, the Appellate Division analyzed the term “palliative” with regard to a respondent’s liability to provide medical treatment. In Hanrahan v. Township of Sparta, 284 N.J. Super. 327 (App. Div. 1995), the court held that an employer is required to provide such treatment if there is (1) competent medical testimony that (2) the treatment is both reasonable and necessary to (3) cure or relieve the effect of the work-related injury such as to improve ability to function. Prior to that time, defense counsel would use “palliative” as an indicator to cease liability. Per this decision, that is not the legal analysis.

However, according to the court, “palliative” treatment could cease if it is no longer curing or relieving the effect of the work-related injury to improve one’s ability to function. Therefore, a practitioner should determine whether these requirements apply when addressing this issue.

2004–2014

The next decade, 2004–2014, brought about additional significant events. The world was introduced to Facebook (2004) and saw the election of Barack Obama as President of the United States (2009). This decade also included the death of music icon Michael Jackson (2009). In addition to these events, this decade brought about important judicial decisions in New Jersey workers’ compensation. Next, we will take a look at one of them.

In 2006, the Appellate Division addressed the issue of entitlement to temporary total disability benefits when an injured worker is terminated from employment for reasons unrelated to the work-related injuries and is, thereafter, placed out of work or on modified duty status by the medical doctor. In Cunningham v. Atlantic States Cast Iron Pipe Co., 386 N.J. Super. 423 (App. Div. 2006), the court held that a former employee has the burden of proving that they would have been employed “but for” the work-related disability in order to receive temporary disability benefits. In other words, the work-related disability has to be the reason for the unemployment, not something else. 

It is important for practitioners to ask additional questions when a former employee is placed out of work or on modified-duty status following termination. Specifically, practitioners should inquire whether there was any active employment elsewhere, receipt of unemployment benefits, or proof of an active search for employment at the time of the medical change-in-work status. If the lack of employment was due to some other reason (i.e., simply had not sought employment since termination of employment or personal reasons unrelated to the work injury), there would be an argument that temporary total disability benefits are not due. Thorough investigation is key.

2014—2024

Lastly, 2014–2024. During this period, the world witnessed the marriage of Prince Harry and Meghan Markle (2018) and continues to be impacted by the COVID-19 pandemic (2020). In New Jersey, Chief Judge Maria Del Valle Koch was appointed as the first woman Director and Chief Judge of the Division of Workers’ Compensation (2022). In addition to these events, there continues to be important legal decisions. Of those, we will take a look at one New Jersey Supreme Court decision. 

In 2021, the court analyzed the compensability issue related to employee volunteers in Goulding v. NJ Friendship House, Inc., 245 N.J. 157 (2021). The court reiterated that an injury is compensable where there was compulsion by the employer for the employee to volunteer and that injuries during purely social or recreational events are not compensable. The court also reviewed the two-prong test used in analyzing the compensability issue for employees volunteering at employer-sponsored events: (1) whether the injury was a “regular incident of employment” and (2) whether the event provided a benefit to the employer beyond improvement in employee health and morale. 

When encountering this issue, practitioners should apply the two-prong test to the facts of the claim to determine if it is met. Analysis is very fact sensitive. As such, it is worthwhile to conduct a thorough investigation. 

The review of these decisions shows that, although a decision may have been rendered many years ago, it is necessary to be aware of it as it may continue to impact claims handling today. These decisions and analyses can influence your decision as to whether to provide compensation. Defense Digest will continue to be a source of information on legal trends, cases, and updates in the law. 

*Angela is a shareholder and member of our Workers’ Compensation Department. She works in our Mount Laurel, New Jersey, office. 

 

Defense Digest, Vol. 30, No. 4, December 2024, is prepared by Marshall Dennehey to provide information on recent legal developments of interest to our readers. This publication is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. ATTORNEY ADVERTISING pursuant to New York RPC 7.1. © 2024 Marshall Dennehey. All Rights Reserved. This article may not be reprinted without the express written permission of our firm. For reprints, contact tamontemuro@mdwcg.com.

Firm Highlights

Defense Victory Obtained in Workers’ Compensation Case

Result

Defense Victory Obtained in Workers’ Compensation Case

Thought Leadership

The Tolling Trap: Filing Alone Will Not Toll the Statute Without Good-Faith Service

The Eastern District of Pennsylvania recently reinforced a critical limitation on bad faith claims, holding that a timely filing alone will not preserve a cause of action absent a good-faith effort to serve the original process. The plaintiff had presented a claim for underinsured motorist benefits to his auto insurer. The insurer evaluated the claim and determined that the plaintiff’s accident-related damages did not exceed the bodily injury liability insurance limits of the at-fault driver and denied his claim. Among other claims, the plaintiff sought to present a claim for insurance bad faith under 42 Pa. C.S.A. § 8371, to which a two year statute of limitation applies. He first filed a praecipe for writ of summons before the expiration of the statute of limitation. However, the plaintiff did not attempt to serve the praecipe or writ until after the statute of limitations had expired. Additionally, the service failed as the plaintiff had mailed the original process to an incorrect address. Despite receipt of the Postal Service’s failure to deliver the original process, the plaintiff did not attempt to re-serve the writ. Two months later, the plaintiff filed a complaint and then successfully served that complaint. The insurer sought to dismiss the plaintiff’s bad faith claim as time-barred by the statute of limitations. The district court agreed. Though the plaintiff had filed a praecipe for a writ of summons prior to the expiration of the statute of limitations, the statute is only tolled if there is a good faith effort to serve that original process. In this case, the court determined that the plaintiff had failed to perform a “good faith effort to serve the original process”. Additionally, though the filing and service of a complaint can serve as alternative original process when the lawsuit is commenced by the filing of a praecipe for a writ of summons, the plaintiff filed his complaint after the statute of limitations had expired. The plaintiff’s bad faith claim was therefore determined to be barred by the statute of limitations and dismissed by the court, with prejudice. A key takeaway for the defense is not to assume that the statute of limitations has been successfully tolled by a plaintiff merely because a praecipe for a writ of summons or complaint has been filed prior to the expiration of the statute. A filed complaint or writ is only part of the equation. The defense should carefully review the docket and filings to confirm that the plaintiff also performed the requisite good faith effort to serve that original process. A thorough review of the docket may reveal that the plaintiff failed to make the good-faith service efforts necessary to toll the statute of limitations.

business meeting photo

Result

Summary Judgment Obtained in Insurance Coverage Case

Thought Leadership

Florida Supreme Court Rules Florida Statute §627.70152 Does not Apply Retroactively

In a decision that resolves years of appellate uncertainty and confirms that insurers and insureds alike can rely on the legal framework in place when a policy is issued, the Supreme Court of Florida last week found that Florida Statute §627.70152, which involves an insured’s requirement to provide an insurer with pre-suit notice before filing a suit, cannot be applied retroactively. In Universal Property & Casualty Insurance Company v. Hughes, the Court was presented with the issue of whether the statutory pre-suit notice requirement applied retroactively and whether it would apply to a breach of contract of an insurance policy that was issued before the statute went into effect. Before the Court was an appeal from a homeowner, Ms. Hughes, who sued her insurance carrier, Universal Property & Casualty Insurance Company (Universal) for breach of contract under an insurance policy that was in effect from April 24, 2019 through April 24, 2020. During the policy period, Ms. Hughes suffered a loss and, on May 29, 2019, made a claim for water damage. The carrier investigated the loss and issued payment; Ms. Hughes disputed the payment, finding the amount insufficient for repairs. On July 1, 2021, Florida Statute §627.70152 went into effect, which required insureds to provide notice of intent to initiate litigation against the carrier prior to filing a lawsuit; if an insured filed the lawsuit without complying with §627.70152, a court must dismiss the case without prejudice. On August 4, 2021, Ms. Hughes filed her lawsuit against Universal for breach of contract. Universal moved to dismiss based on her failure to comply with §627.70152. Ms. Hughes contended the notice requirement could not be applied retroactively. The trial court disagreed and dismissed the lawsuit without prejudice, and Ms. Hughes appealed. During the appeal, the Fourth District Court of Appeal, in Cole v. Universal Property & Casualty, 363 So. 3d 1089 (Fla. 4th DCA 2023), ruled that Florida Statute §627.70152 did apply retroactively to policies issued before the effective date of §627.70152. However, the Sixth District Court agreed with Ms. Hughes and overturned the trial court’s ruling, finding the statute could not retroactively apply to policies issued prior to the statute effective date. Thereafter, the other district courts weighed in, with the Third District Court agreeing with the Fourth District Court, and the First, Second and Fifth District Courts agreeing with the Sixth District Court. In resolving the conflict amongst the district courts, the Supreme Court advised “as a general rule, ‘the statute in effect at the time an insurance contract is executed governs substantive issues arising in connection with that contract.’ Hassen v. State Farm Mut. Auto. Ins. Co., 674 So. 2d 106, 108 (Fla. 1996). The Court applied the two-step test when deciding whether a statute has retroactive application: “First, the Court must ascertain whether the Legislature intended for the statute to apply retroactively. Second, if such an intent is clearly expressed, the Court must determine whether retroactive application would violate any constitutional principles.” Menendez v. Progressive Exp. Ins. Co., 35 So. 3d 873, 877 (Fla. 2010). In analyzing the Legislature’s intent, the Court must determine whether the Legislature has manifested a clear command for retroactivity in the statutory text.  In review of the statutory text, the Court found nothing in the language of the statute to indicate that the phrase “all suits” was serving another purpose of expanding its reach to suits based on policies that both predate and postdate the enactment of the statute. Buis v. Universal Prop. & Cas. Ins. Co., 394 So. 3d 738, 741 (Fla. 2d DCA 2024). Further, the Court noted the statute has an effective date, which has long been considered to be evidence against retroactive application of a statute. The Court concluded that, on its face, no provision of §627.70152 speaks to application of the statute to insurance policies issued before the statute’s effective date and therefore, the Legislature did not clearly command retroactivity of the statute to include insurance policies issued prior to the enactment of the statute. The Court briefly reviewed Universal’s argument that the presuit notice requirement was procedural, not substantive, and therefore should be applied retroactively; however, the Court agreed with the Sixth District Court’s finding that, in its entirety, §627.70152 transformed an insured’s ability to sue an insurance company under a property insurance policy and an insurer’s obligations to respond to and pay insurance claims, thus making the requirement a substantive change. The Court thereby upheld the decision of the Sixth District and disapproved the decision of the Fourth District in Cole.

Bret E. Dubbert Joins Marshall Dennehey’s Orlando Office as Special Counsel in the Casualty Department

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Thought Leadership

New Jersey Appellate Division Affirms Recreational Immunity for County Under Landowners' Liability Act

In a recent unpublished decision in Matthew Kuzma, etc. v. Middlesex County Parks Department, et al., the New Jersey Appellate Division affirmed summary judgment in favor of Middlesex County Parks Department, holding that the county was immune from liability under New Jersey's Landowners' Liability Act (LLA), notwithstanding its failure to plead the immunity as an affirmative defense in its answer to the Complaint. The case arose from injuries sustained by fourteen-year-old plaintiff, Matthew Kuzma, while playing basketball at Spring Lake Park in South Plainfield on August 23, 2019. The plaintiff observed a crack in the basketball court before beginning to play but did not consider it dangerous. During the game, his foot became caught in the crack, causing him to fall and suffer a significant ankle injury. The plaintiff alleged that the injury resulted in ongoing physical limitations and deprived him of the opportunity to play collegiate basketball. The plaintiff filed suit alleging that the defendants negligently maintained the basketball court. Although the county did not assert LLA immunity as an affirmative defense in its answers, it later moved for summary judgment on that basis. The plaintiff opposed the motion, arguing that the county had waived the defense by failing to plead it. The county maintained that the plaintiff had received sufficient notice of its intent to rely on the LLA through discovery and therefore suffered no unfair surprise or prejudice. The trial court agreed and granted summary judgment, concluding that the county should be permitted to invoke statutory immunity notwithstanding its failure to formally plead the defense. Relying heavily on the New Jersey Supreme Court's guidance in Arias v. Cnty. of Bergen, holding a county park was subject to the immunity of the LLA, the Appellate Division affirmed, holding that the county's failure to plead LLA immunity did not preclude reliance on the defense under the circumstances presented. The court determined that the plaintiff had received adequate notice of the immunity claim through discovery and that permitting the defense furthered the public-policy objectives embodied in the LLA. In affirming dismissal, the Appellate Division acknowledged the seriousness of the plaintiff's injury and the general societal interest in maintaining parks and recreational facilities in a safe condition. However, the court emphasized that both the legislature and the New Jersey Supreme Court have expressed a clear policy choice to limit liability for public and private landowners who make recreational property available for public use. The decision reinforces the courts' continuing adherence to the Landowners' Liability Act and the principle that recreational lands and facilities should be broadly protected from liability exposure, even in cases involving significant personal injuries.

Complete Victory Obtained in a Workers’ Compensation Matter

Result

Complete Victory Obtained in a Workers’ Compensation Matter

Event

CLM 2026 Focus Conference

Allison joins three insurance industry leaders to discuss how cyber coverage disputes, the growing impact of social inflation on bodily injury claim valuation, and the use of artificial intelligence are reshaping the bad faith landscape. The panel will examine emerging sources of extra-contractual exposure, including evolving cyber insurance coverage issues and the challenges of accurately valuing bodily injury claims. Practical approaches to claim evaluation using AI, along with defense strategies designed to help prevent or successfully defend against bad faith litigation, will also be addressed. 

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