Personal Injury Law Journal

What are the factors a court will review in deciding if an on-the-job heart attack is compensable?

The New Jersey Workers' Compensation Act has a specific provision addressing cardiovascular and cerebral vascular (stroke) injuries. Section 7.2 of the Act provides, "In any claim for compensation for injury or death from cardiovascular or cerebral vascular causes, the claimant shall prove by a preponderance of the credible evidence that the injury or death was produced by the work effort or strain involving a substantial condition, event or happening in excess of the wear and tear of the claimant’s daily living and in reasonable medical probability caused in a material degree the cardiovascular or cerebral vascular injury or death resulting therefrom."

"Material degree" means an appreciable degree or a degree substantially greater than de minimus.

Obviously this is one of the more difficult areas of Workers’ Compensation law, and a worker who suffers a heart attack on the job should consult a qualified workers' compensation attorney. A key issue here is the work effort was and whether it was in excess of the worker’s daily living. Our courts have interpreted this not as a comparison of the work effort at the time of the attack but rather a comparison of that work effort with the wear and tear of the person’s daily living outside of work.

A second important point to consider are the medical proofs available. What was the worker’s health before the attack? How much time passed between the work effort and the attack? Obviously these complicated issues should always be handled by a qualified workers' compensation attorney such as those here at Stark & Stark.

Alfred Vitarelli is a Shareholder in Stark & Stark's Marlton, New Jersey office, concentrating in Workers’ Compensation Law. For more information, please contact Mr. Vitarelli.

The New Jersey Workers’ Compensation Statute section  N.J.S.A. 34:15-17 requires injuries to be reported within 90 days of a work accident.  A recent case, Ader v. Lebanon Township, addresses this section of the statute, and confirms the importance of reporting accidents within 90 days. This section of the statute is designed to give the employer the benefit of timely investigation into the accident.  The employee in the above case waited 15 months to report his injury to his employer, and thus was denied workers’ compensation benefits by the court.

The employee worked as a volunteer EMT for the Township of Lebanon.  On November 18, 2008, this employee climbed onto the back of a tow-truck to investigate an accident, and when he jumped off of the truck he felt pain in his low back.  He did not report this accident to his employer or request medical care.  A few weeks later he felt pain in his hips so he went to his own doctor and spoke about the work incident jumping off of the truck, but not until two months after the accident.  Eleven months after the accident his own doctor sent him to a surgeon who diagnosed a serious condition that would require hip replacements.  The employee told the surgeon about the pain he experienced after jumping off of the tow-truck at work.  The employee finally reported the accident to the Township in February of 2010.

The Township denied the claim on the basis of the above “Notice” statute, and took the position that this employee waited too long to report his injury.  The employee’s position was that he really did not know his condition was work related until the surgeon told him so.  The Court rejected his argument, and found that the employee knew he was injured on November 18, 2008, or shortly thereafter, and held that he should have reported the event to his employer within 90 days.  He certainly knew of the relationship when he saw his own doctor a few weeks after the accident.

This recent case shows how important it is to notify your employer as soon as possible if you get injured at work.  Even if you do not feel you need medical care immediately, it is still best to cover yourself by letting your employer know you were involved in an accident.  And certainly the minute you feel you need medical care you must let your employer know you were injured at work, and ask for medical treatment.  Then call Stark & Stark and we can help you through the process.

Marci Hill Jordan is a Shareholder in Stark & Stark’s Marlton, New Jersey office, concentrating in Workers’ Compensation Law. For more information, please contact Ms. Jordan.

The final step in a workers’ compensation claim is the payment of partial or total permanency benefits to the injured worker. My clients frequently ask me if their spouse or family will receive their benefits it they die either before they get their permanency award, or during the pendency of the award. The answer to this question depends on the cause of death, and whether or not the injured worker has “dependents” as defined by law. There are several sections of the New Jersey Statute that address these issues:

N.J.S.A. 34:15-12 (e) addresses the issue of what happens when a person has been awarded partial or total permanency benefits and then they die. The statute says that if the person dies from any cause other than the work accident during the time period that they are receiving benefits for a permanent injury, the remaining benefits will be paid to the deceased person’s dependents. If there are no dependents the remaining money, not to exceed $3500, will be paid in a lump sum to the proper person for burial and funeral expenses. However in the case where a person is receiving total and permanent disability benefits, no payments are due to anyone else other than the injured worker after benefits have been paid in excess of 450 weeks.

N.J.S.A.34:15-13 (h) addresses the issue of what happens if the death results from an accident or occupational disease. In that case, whether there are dependents or not, the workers’ compensation carrier pays for the medical bills for the final illness and the funeral costs not to exceed $3500. In addition, the statute provides for an ongoing weekly compensation to dependents only, not to exceed a total of 70% of wages, up to a maximum set yearly by statute.

N.J.S.A.34:15-13 (f) defines “dependents” for workers’ compensation purposes. Of course a spouse or minor child being supported by the decedent are included in this definition. However there are other categories of dependents, and the statute must be reviewed carefully to make a final determination. Of note, a fiancé or “common law” spouse are not included in this definition.

 Please contact the Workers’ Compensation Attorneys at Stark and Stark for any questions about workers’ compensation benefits.

 Marci Hill Jordan is a Shareholder in Stark & Stark’s Marlton, New Jersey office, concentrating in Workers’ Compensation Law. For more information, please contact Ms. Jordan.

In a another blog post, I explained that you have 90 days to report a work injury in New Jersey.   What happens when your employer has a different policy?   Employers are allowed to create their own internal deadlines for reporting injuries.   Often employers will require reporting on the job injuries within 24 or 48 hours.   Does this mean your employer can permanently deny your workers’ compensation claim?  No.

However, if you take too long to report a claim, your employer or its insurance carrier will very likely deny your claim.   This means you’ll have an uphill battle to receive workers’ compensation benefits.   

An employer can require you to report an injury within a certain amount of time just like it can require you to arrive to work on time every day.    If you are consistently late, your employer will discipline or terminate you.   If an employer policy regarding accident reporting only applies internally, you are still protected by the workers’ compensation statute when it comes to your worker’s compensation benefits.    

Under New Jersey Law, you can receive workers’ compensation benefits as long as you report the injury within 90 days.   It is very important to understand this difference.  The workers’ compensation statute does NOT protect you from discipline for violating your employer’s policy.   

For instance, an employer can require all accidents to be reported the same day or within 24 hours.   These policies are permissible, and if you do not follow them you could be subject to reprimand or further discipline, including termination, from your employer.  Even though this is different than the workers’ compensation requirements under the New Jersey Workers’ Compensation statute, it is allowed because it doesn’t actually impact your right to workers’ compensation benefits.  

What if your employer requires that all accidents are reported within 24 hour?    If you injure yourself at work on a Friday and wait to report it because you want to see how your injury feels over the weekend, then your employer can discipline you for failing to report the injury within 24 hours.  You could receive a write up or possibly be terminated for failing to follow your employer’s policy.   

However, your employer cannot deny you workers’ compensation benefits if you report an accident within 90 days due to the worker’s compensation statute.   A specific injury is one that you can pinpoint the time and place of when you were injured.   This is different than a repetitive stress injury that occurs over a period of time from performing the same strenuous activities over and over at work.   This does NOT mean your employer or it’s workers’ compensation carrier won’t deny your claim.  

Employers enact their own internal reporting requirements for several reasons.   The quicker the accident is reported, the sooner they can investigate the claim.    Employers are looking for other causes to an injury, and the longer you take to report an injury, the more likely your employer will look to show that it is not work related.

As I’ve said before, if you’re hurt at work, report it when it happens.   You will not do yourself any favors by failing to report an on the job injury.   

James Creegan is a Shareholder in Stark & Stark's Lawrenceville, New Jersey office concentrating his practice in Workers' Compensation law. For questions, or to schedule a free consultaiton with Mr. Creegan, please contact him here.

Our Worker’s Compensation Act here in New Jersey contains a provision regarding Fraud. While many people assume it refers to false or misleading claims by workers, in reality it applies to employers as well. This was illustrated recently by two recent cases handled by the Office of the Insurance Fraud Prosecutor. In the first case a company under-reported the number of its employees and wages to its workers compensation insurance company. By doing so it gave the false impression to the insurance company that it was entitled to lower compensation premiums. The company pled guilty to this charge and was ordered to pay restitution to the insurance company in the amount of $75,000.

In the second case a company provided false and misleading information to its insurance company to lower its premiums. It not only under-reported the amount of its payroll but also misrepresented the type of work performed by its employees. In setting workers compensation insurance premiums insurance companies take into account the amount of employees, the amount of the payroll, the type of work performed, and other factors. In this case the Insurance Fraud Prosecutor determined the company stole a total of more than $315,000 from its worker’s compensation insurance company, and also failed to file tax returns and underreported wages to the State. In addition to restitution, the president of the company is facing the possibility of jail time.

These types of insurance fraud are clearly contrary to the intent of the New Jersey Worker’s Compensation Act, which is to ensure that injured workers are fairly compensated according to the law. Fraud by employers such as this clearly shows their contempt for this lawful process.

Alfred Vitarelli is a Shareholder in Stark & Stark’s Marlton, New Jersey office, concentrating in Workers’ Compensation Law. For more information, please contact Mr. Vitarelli.