New Jersey Workers' Compensation Case Alert

04.28.14

Category: New Jersey

Judge Ingrid French dismissed a claim filed by a medical provider for additional reimbursement of a bill on April 4, 2014. Cape Regional Medical Center filed a Medical Provider Application alleging that it is due additional payment for services rendered to petitioner, Jeffrey Davis, in connection with a pending workers' compensation claim. Cape Regional provided services in NJ, for this NJ resident, who was injured in Pennsylvania and filed a workers' compensation claim in Pennsylvania. The employer is a California company. The underlying workers' compensation claims were still pending at the time of this decision. The Pennsylvania insurance carrier, Zurich, authorized the NJ treatment. The bills were allegedly submitted to Zurich and paid pursuant to Pennsylvania law. Cape Regional filed an action in NJ looking for additional payment.
 
Judge French reviewed the PA code, the NJ Workers' Compensation Statutes regarding medical provider applications and case law mentioned by petitioner’s counsel. The Judge determined that in order to proceed with a medical provider application, the NJ Court must have subject matter jurisdiction over the underlying workers' compensation claim. The petitioner (provider) must show that regardless of whether petitioner has actually filed a NJ claim, there must be proofs presented that the underlying petitioner has a viable NJ workers' compensation claim. Judge French held that NJSA 34:15-7, “places the medical provider on notice that they will be expected to prove the Court’s subject matter jurisdiction over the disputed bill.” “Access to the NJ Workers' Compensation Courts by a medical provider … is restricted to only those providers who can “attest” to the compensability of the employee/patient’s injury by an accident in New Jersey.” Cape Regional was unable to present proofs showing that the petitioner if he elected, could have pursued a NJ workers' compensation claim for his underlying injury. Since Cape did not meet this burden, the claim was dismissed.
 

For more information please contact Robert Hanneman Jr. at rhanneman@wglaw.com or 856.779.7010.

Media Contacts

Sara L. De Long
267.295.3377
sdelong@wglaw.com

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