Callagy Law Arizona: nj workers comp

The purpose of this post is to help assist those with questions they have concerning their business or medical practice. The Callagy Law team is knowledgeable in many law practice areas and will frequently post topics ranging from Medical Revenue Recovery, PIP, Workers Compensation, and Commercial Insurance. We hope to have this blog shed a light on many common questions.

The New Jersey Workers’ Compensation Law established the Uninsured Employer’s Fund (UEF) in order to provide benefits for any employee injured while working for an employer who did not have the required workers’ compensation insurance coverage. Benefits from the Uninsured Employer’s Fund also paid to an injured employee when an uninsured employer does not pay the benefit payments awarded by the Division of Workers’ Compensation. The benefits provided by the Uninsured Employer’s Fund include payment of medical expenses and temporary disability benefits. These benefits are administered by The Office of Special Compensation Funds (OSCF).

When a Petitioner files a Claim Petition, the insurance carrier or the approved self insurance of the employer is indicated on the application. If none is provided, then a search is performed with the Compensation Rating & Inspection Bureau to identify the whether the employer is uninsured. In the employer is determined to have no workers’ compensation coverage, then an attorney for the Uninsured Employer’s Fund will be assigned to the claim and will appear at the scheduled court proceedings.

We hope you found the information provided in this article helpful to various questions you may have had concerning the healthcare industry. For information pertaining to our services for medical providers, please click here. Please note, Callagy Law has recovered over $200,000,000 for medical providers, and that number grows daily. Please free to reach out to Sean Callagy of Callagy Law at any time for questions you may have concerning personal and business matters. Callagy Law offices are located conveniently in Paramus, NJ. Beyond the scope of information, Sean Callagy has developed multiple areas of our healthcare legal practice and business coaching. Feel free to connect with us on Facebook, Twitter or LinkedIn! Additionally you can subscribe to our daily videos on YouTube.

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Uninsured Employer’s Fund for New Jersey Workers’ Compensation Claims

How does third-party liability affect a New Jersey Workers’ Compensation claim for a medical provider petitioner?

N.J.S.A. 34:15-40 (“Section 40”) provides that

Where a third person is liable to the employee or his dependents for an injury or death, the existence of a right of compensation from the employer or insurance carrier under this statute shall not operate as a bar to the action of the employee or his dependents, nor be regarded as establishing a measure of damage therein. In the event that the employee or his dependents shall recover and be paid from the said third person or his insurance carrier, any sum in release or in judgment on account of his or its liability to the injured employee or his dependents, the liability of the employer under this statute thereupon shall be only such as is hereinafter in this section provided.

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(b) If the sum recovered by the employee or his dependents from the third person or his insurance carrier is equivalent to or greater than the liability of the employer or his insurance carrier under this statute, the employer or his insurance carrier shall be released from such liability and shall be entitled to be reimbursed, as hereinafter provided, for the medical expenses incurred and compensation payments theretofore paid to the injured employee or his dependents less employee’s expenses of suit and attorney’s fee as hereinafter defined.

(c) If the sum recovered by the employee or his dependents as aforesaid is less than the liability of the employer or his insurance carrier under this statute, the employer or his insurance carrier shall be liable for the difference, plus the employee’s expenses of suit and attorney’s fee as hereinafter defined, and shall be entitled to be reimbursed, as hereinafter provided for so much of the medical expenses incurred and compensation payments theretofore paid to the injured employee or his dependents as exceeds the amount of such difference plus such employee’s expenses of suit and attorney’s fee.

Simply, Section 40 prevents double recovery by workers’ compensation claimants by allowing the respondent carriers to assert a lien against a potential third-party lien. A petition is prohibited from recovering from both the respondent carrier and a liable third-party, thereby allowing the respondent carrier to subrogate against the third-party.

A Section 40 lien is limited to medical treatment costs and disability payment (temporary and permanent), as it does not cover the respondent carrier’s medical examination defense costs, such as Independent Medical Examinations. A respondent carrier’s recovery from a third-party under Section 40 is limited to the amount paid less petitioner’s counsel fees, which are typically one-third. Therefore, the carrier will likely be allowed to recover two-thirds of the total payments from the third-party.

We hope you found the information provided in this article helpful to various questions you may have had concerning the healthcare industry. For information pertaining to our services for medical providers, please click here. Please note, Callagy Law has recovered over $185,000,000 for medical providers, and that number grows daily. Please free to reach out to Sean Callagy of Callagy Law at any time for questions you may have concerning personal and business matters. Callagy Law offices are located conveniently in Paramus, NJ. Beyond the scope of information, Sean Callagy has developed multiple areas of our healthcare legal practice and business coaching. Feel free to connect with us on Facebook, Twitter or LinkedIn! Additionally you can subscribe to our daily videos on YouTube.