In Johnnie Jackson v. Township of Montclair, Mr. Jackson injured his right knee while moving books at the Montclair Public library during the course of his employment on August 4, 2008. He was provided with medical care through the workers compensation carrier, including surgery on his knee. The workers’ compensation doctors wrote in their reports that Mr. Jackson denied any prior right knee injuries. Contrary to what he told the treating doctors, Mr. Jackson had been involved in an automobile accident on April 13, 2007 and had treated with a surgeon who ordered an MRI that revealed significant problems in this same knee, and who had recommended surgery. Mr. Jackson did not have knee surgery after the car accident. Mr. Jackson filed a law suit for the car accident, and signed statements under oath that the knee injury he sustained in the car accident was permanent in nature, and caused pain on a daily basis.
The Township of Montclair ultimately sent Mr. Jackson to a doctor for an Independent Medical Exam for the work injury. That doctor became aware of the prior motor vehicle accident where Mr. Jackson injured this same knee. After review of the records from the motor vehicle accident this doctor stated that the work injury only caused a sprain and strain of the right knee, and that the recent surgery was really needed because of the injuries that happened in the motor vehicle accident, not the work accident. A trial of the workers’ compensation case took place where Mr. Jackson testified that before the work injury of 8/4/2008 his right knee felt great. When cross examined with the contrary sworn statements from his motor vehicle law suit, he testified that some of those statements had been wrong, and that he had signed them without reviewing them. Mr. Jackson also testified that he did not recall being told that he had a tear in his right knee after the car accident, but later admitted being told that he needed surgery. He said he had no idea why the treating workers’ compensation doctors had no knowledge of the prior car accident.
Montclair Township filed to dismiss Mr. Jackson’s worker’ compensation claim alleging he violating the New Jersey Fraud Act by failing to tell the workers’ compensation treating doctors about his prior right knee injury. The Judge of Compensation dismissed the workers’ compensation case finding fraud, and ordered Mr. Jackson to pay back to the workers’ compensation carrier most of the benefits they had paid on his behalf, including benefits paid for medical care. Mr. Jackson appealed, and the Appellate Division agreed with the Workers’ Compensation Judge’s finding that since he had explicitly denied having any prior right knee injuries, he had committed fraud in the workers’ compensation case.