CENTER VERSUS MALOUF CHEVROLET-CADILLAC LACK INCORPORATED. CAN WE PLEASE HAVE APPEARANCES
OF UM COUNSEL? APPELLANT: MAY IT PLEASE THE COURT, DAVID KENDALL FROM THE
LAW OFFICES OF ANNE DEBELLIS. APPELLANT1: MAY IT PLEASE THE COURT,
FLORENCE LAMB ON BEHALF OF THE PETITIONER CAFE BAYOU. APPELLANT1: SUSAN
STRIKER ON BEHALF OF AMICI CURIAE INSURANCE COUNCIL OF NEW JERSEY.
RESPONDENT: MICHAEL DICICCO FOR THE RESPONDENT PLASTIC SURGERY CENTER.
APPELLANT2: GOOD MORNING. STEPHEN STADTMAUER ON BEHALF OF RWJ BARNABAS HEALTH, HACKENSACK
MERIDIAN HEALTH, VALLEY HOSPITAL AND ATLANTIC CARE. SPEAKER: MICHAEL SUBMIT
K-1. CHIEF JUSTICE RABNER: WELCOME, COUNSEL. WE ARE BLESSED WITH AN
ABUNDANCE OF HELP IN THIS CASE. I'M GOING TO ENCOURAGE YOU TO ADOPT ARGUMENTS THAT YOU'VE
HEARD BEFORE RATHER THAN REPEAT TO THE EXTENT THAT MAKES SENSE THIS MORNING.
MR. KENDALL, PLEASE GO AHEAD. APPELLANT: MAY IT PLEASE THE R COURT WITH
THE COURT'S PERMISSION IF I MAY RESERVE FIVE MINUTES OF MY TIME FOR REBUTTAL IN THE EVENT
ANY REBUTTAL IS NECESSARY. CHIEF JUSTICE RABNER: WE'LL HAVE YOU BACK PERHAPS
FOR A LITTLE LESS THAN THAT. PLEASE GO AHEAD. APPELLANT: VERY WELL. THANK YOU,
JUDGE. WE'RE HERE TODAY, YOUR HONORS, BECAUSE THE APPELLATE DIVISION ERRED
IN REVERSING JUDGE MARTINO'S CAREFULLY REASONED AND CLEARLY ARTICULATED DECISION IN WHICH
HE FOUND THAT A TWO-YEAR STATUTE OF LIMITATIONS APPLIED. THE APPELLATE DIVISION ERRED
BY EQUATING MEDICAL PROVIDER CLAIMS WITH CONTRACT CLAIMS. WE ARE NOT. THE APPELLATE DIVISION
ERRED BY EXPANDING THE JURISDICTION OF THE DIVISION OF WORKERS COMPENSATION TO SIX
YEARS. THE APPELLATE DIVISION ERRED BY CONCLUDING THAT THE CLAIMANTS IN THE DIVISION ARE
UNDERSTOOD TO BE INJURED WORKERS. THAT'S SIMPLY NOT THE CASE. AND THE APPELLATE DIVISION
ERRED BY FAILING TO AFFORD JUDGE MARTINO THE DEFERENCE TO WHICH HIS DECISION SHOULD HAVE
BEEN ENTITLED AS THE JUDGE WITH THE EXPERTISE CHARGED WITH ADMINISTERING THE PROVISIONS
OF THE WORKER'S COMP LAW. AS A RESULT, FILINGS IN THE DIVISION OF WORKER'S
COMP OF MEDICAL PROVIDER CLAIMS HAVE INCREASE M.D. THE PAST YEAR PLUS SINCE THE DECISION.
RIGHT NOW 22 PERCENT OF ALL OF THE CLAIMS OF ALL OF THE NEW CLAIMS IN THE DIVISION ARE
MEDICAL PROVIDER CLAIMS. THIS IS THE DIVISION OF WORKER'S COMP THAT IS SLOWLY BEING
OVERRUN BY THESE FILINGS OF MEDICAL PROVIDER CLAIMS. AND MY EXPANDING THE JURISDICTION
TO SIX YEARS, I PERSONALLY HAVE ANSWERED CLAIM PETITIONS THAT DATE BACK FOUR OR FIVE YEARS
FOR DATES OF SERVICE THAT WOULD OTHERWISE BE BARRED BY A TWO-YEAR STATUTE OF LIMITATIONS.
TO UNDERSTAND THE SIGNIFICANCE OF THE ERRORS IN THE APPELLATE DIVISION DECISION
IN THIS CASE, THE NATURE OF THE MEDICAL PROVIDER CLAIMS HAS TO BE CLEARLY UNDERSTOOD.
WHEN AN INJURED WORKER RECEIVES TREATMENT, THERE IS NO QUESTION A CONTRACT FORMED BETWEEN
THE INJURED WORKER AND THE MEDICAL PROVIDER. THEY GO IN, THEY FILL OUT THE PAPERWORK.
WE'VE ALL DONE IT. WE'VE SIGNED OUR NAMES AND AGREED TO BE RESPONSIBLE FOR THE PAYMENT
OF WHATEVER THE CHARGES ARE. HOWEVER, IF THE INJURY IS A WORK-RELATED
INJURY, THE LEGISLATIVE AMENDMENT TO SECTION 15 IN 2012 EXTINGUISHES THAT CONTRACT. WHY?
BECAUSE THE EMPLOYER IS RESPONSIBLE FOR PROVIDING TREATMENT FOR WORKER'S COMP INJURIES.
ANY WORK-RELATED INJURY, THE PETITIONER DOES NOT HAVE TO PAY FOR. THE TREATMENT IS ALL
THE RESPONSIBILITY OF THE EMPLOYER. SO THE CONTRACT IS EXTINGUISHED. NOW,
IF THE INJURIES ARE NOT WORK RELATED, THE CONTRACT DOES REMAIN, BUT THE NATURE OF THE
INJURIES AND THE NATURE OF THE CIRCUMSTANCES WHEN THE TREATMENT IS PROVIDED DETERMINED
WHAT KIND OF CLAIM CAN BE PURSUED. JUSTICE ALBIN: HOW IS A PHYSICIAN TO
KNOW WHETHER THE INJURY IS WORK RELATED? HE'S NOT THERE. HE WASN'T AT THE ACCIDENT SCENE.
APPELLANT: THAT'S TRUE. BUT WHEN AN INJURED WORKER -- WHEN AN INJURED PERSON
-- JUSTICE ALBIN: BECAUSE YOU'RE SAYING ONE'S A CONTRACT, ONES NOT A CONTRACT.
SOMEONE WITH AN INJURY COMES TO A DOCTOR. MAYBE HE CHECKS OFF IT'S WORK RELATED, MAYBE
HE DOESN'T CHECK THAT IT'S WORK RELATED. HOW IS THE PHYSICIAN SUPPOSED TO MAKE A
DETERMINATION THAT THIS IS A VIABLE WORK-RELATED INJURY THAT IS COMPENSABLE UNDER THE WORKER'S
COMP REGIME? APPELLANT: DURING THE COURSE OF THE TREATMENT, THE DOCTORS
ORDINARILY TAKE A HISTORY. WHATEVER THE CIRCUMSTANCES OF THE ACCIDENT MAY BE. IF THE
PERSON SAYS I WAS AT WORK AND FELL OFF A STAFF FOLDING OR TRIPPED OVER A ROCK OR WHATEVER
THE INSTANCE IS, THAT HISTORY IS IN THE DOCTOR'S RECORDS. IF IT'S NOT IN THE DOCTOR'S
NOTES ITSELF, HIS IN-TAKE STAFF, THE NURSING STAFF, THE INFORMATION IS AVAILABLE TO THE
DOCTOR. IN ADDITION, DURING THE COURSE OF THERE'S MORE THAN ONE TREATMENT
PROVIDED. IF THERE'S VISITS ON DECEMBER 1ST, DECEMBER 12TH, DECEMBER 15TH. SOMEWHERE
ALONG THE LINE THE NATURE OF THE CLAIM HAS TO BECOME CLEAR TO THE DOCTOR'S OFFICE.
JUSTICE ALBIN: I'M ASKING YOU THIS QUESTION BECAUSE -- YOU'RE AN EXPERT AND I'M TR
YING TO UNDERSTAND HOW THIS WORKS. APPELLANT: RIGHT. JUSTICE ALBIN:
LET'S SAY THERE'S NO WORKER'S COMP ACTION FILED BY THE WORKER. THE MEDICAL PROVIDER NOW
FILES HIS PETITION IN THE WORKER'S COMP COURT. AND THE EMPLOYER SAYS THIS WASN'T A WORK
-RELATED INJURY. IS THE PHYSICIAN REQUIRED TO NOW PROVE THAT THIS WAS A WORK-RELATED INJURY?
APPELLANT: YES. JUSTICE ALBIN: WHEN THE PHYSICIAN IS A COMPLETE
STRANGER TO THE INCIDENT? APPELLANT: YES. JUSTICE ALBIN:
THAT'S A CRAZY SITUATION, NO? APPELLANT: I DON'T THINK THAT IT IS. BECAUSE
IF IT'S A WORK-RELATED INJURY AND THE DOCTOR KNOWS IT AND THE PETITIONER HASN'T FILED
A CLAIM, THE DOCTOR STILL HAS THE RIGHT TO -- JUSTICE ALBIN: HOW IS THE
PHYSICIAN SUPPOSED TO PROVE IT? APPELLANT: WELL, THE DIVISION OF WORKER'S
COMP HAS SUBPOENA POWER. THIS IS -- JUSTICE ALBIN: YOU'RE TELLING ME THE
PHYSICIAN THOUSAND MERELY IN ORDER TO GET PAYMENT ON WHAT INITIALLY WAS A CONTRACT BETWEEN
HIM AND THE WORKER IS NOW IN THE WORKER'S COMP DIVISION AND NOW HAS -- IT'S UPON HIM TO
PROVE THAT THIS WAS A WORK-RELATED INJURY, HAS TO CALL THE WORKER AND OTHER WITNESSES
TO PROVE IT? APPELLANT: THE SIMPLE ANSWER IS YES. BUT LET ME TAKE A STEP
BACK FROM THE PREMISES OF YOUR QUESTION. BECAUSE WHAT HAPPENS IS, IF AN INJURED WORKER
IS GOING TO FILE A CLAIM PETITION, THE DOCTOR KNOWS -- USUALLY KNOWS ABOUT IT BECAUSE
OF THE HISTORY. BUT IN THESE MEDICAL PROVIDER CLAIMS IN GENERAL, THE CLAIMS ALMOST ALWAYS
-- I SHOULDN'T SAY ALMOST ALWAYS BUT IN A VAST MAJORITY OF THE CASES, THERE'S BEEN A PAYMENT
MADE. AND THE DISPUTE IN THE DIVISION IS ABOUT THE AMOUNT OF THE PAYMENT THAT HAS ALREADY
BEEN MADE. A LOT OF THESE MEDICAL PROVIDER CLAIMS ARE INSISTING THAT THEY ARE ENTITLED
TO MORE MONEY THAN THEY'VE ALREADY BEEN PAID. SO IN PRACTICE, THEY ALREADY KNOW IT'S
A WORK-RELATED INJURY. THEY ALREADY KNOW THEY PROVIDED TREATMENT. THEY ALREADY KNOW
THEY'VE BEEN PROVIDED PAYMENT FOR THIS TREATMENT. JUSTICE PATTERSON: WHAT'S
YOUR RESPONSE TO THE APPELLATE DIVISION's CONCERN THAT THERE WILL BE CLAIMS THAT EXPIRE
BEFORE THEY ACCRUE UNDER A TWO-YEAR STATUTE? APPELLANT: THAT GOES TO ONE
OF THE ERRORS IN THE APPELLATE DIVISIONS DECISION. THE APPELLATE DIVISION FROM
SOMEWHERE CAME UP WITH THE IDEA THAT WE WERE ARGUING THAT THE DATE OF ACCIDENT IS WHEN
A MEDICAL PROVIDER CLAIM ACCRUES. WE NEVER MADE THAT ARGUMENT IN THE APPELLATE DIVISION.
WE DIDN'T MAKE IT AT THE TRIAL LEVEL. AND MOST IMPORTANTLY, JUDGE MARTINO DIDN'T MAKE
THAT FINDING IN HIS DECISION. CHIEF JUSTICE RABNER: SO HOW DO YOU READ
SECTION 51 OF THE STATUTE? SUPPOSE THERE'S A CASE WHERE THERE'S NO SETTLEMENT AND NO PARTIAL
PAYMENT. UNDER THE TERMS OF THE STATUTE, WHEN DID THE MEDICAL SERVICE PROVIDER HAVE TO
FILE THE CLAIM? APPELLANT: THE MEDICAL SERVICE PROVIDER HAS TO FILE THE
CLAIM FROM THE DATE THAT THE SERVICE IS PROVIDED. JUSTICE FERNANDEZ-VINA:
THERE WOULD BE NUMEROUS STATUTE OF LIMITATIONS PERIODS, TWO YEARS FOR THIS SERVICE TODAY
AND COMES BACK TWO WEEKS FROM NOW, SO THAT SERVICE IS STWO YEARS SO IT WOULD BE MULTIPLE
LIMITATION PERIODS? APPELLANT: WELL, THERE WOULD BE MULTIPLE CLAIMS, SO,
YES, THERE WOULD BE MULTIPLE LIMITATION PERIODS. JUST LIKE AN INJURED WORKER WHO FALLS
ON JANUARY 1ST, FALLS AGAIN ON JANUARY 5TH AND FALLS AGAIN ON JANUARY 10TH, HE CAN FILE
THREE CLAIM PETITIONS. JUSTICE FERNANDEZ-VINA: BUT YOU'RE TALKING SEPARATE
INSTANCES. I'M TALKING DIFFERENT TREATMENTS. SAME INJURY, SEVERAL TREATMENTS, AS USUALLY
HAPPENS. DOES THAT MEAN THERE'S A TWO-YEAR STATUTE AS TO THE FIRST TREATMENT FOR THAT
DAY, IT BEGINS TO RUN FOR THE NEXT TREATMENT, A WEEK LATER, SO IT COULD BE MULTIPLE,
HUNDREDS OF LIMITATION PERIODS? APPELLANT: I'M HOPEFUL IT DOESN'T GET TO
HUNDREDS OF PERIODS OF TREATMENT BUT YES. JUSTICE FERNANDEZ-VINA: SOME
INJURIES TAKE A LONG TIME TO TREAT. CHIEF JUSTICE RABNER: I WANT TO GO BACK
TO FOLLOW UP ON JUSTICE PATTERSON's QUESTION. TELL ME IF I'M MISUNDERSTANDING IT. ITS
PLAIN TERMS SUGGEST YOU GET TWO YEARS WHERE THERE HAS BEEN AN AGREEMENT FOR COMPENSATION
THAT'S BEEN BROKEN OR TWO YEARS FROM THE LAST PAYMENT WHERE THERE'S BEEN PARTIAL PAYMENT.
BUT THEN THE STATUTE SAYS, WITHIN TWO YEARS AFTER THE DATE OF THE ACCIDENT OTHERWISE.
NO? APPELLANT: THAT'S EXACTLY WHAT THE STATUTE SAYS AND I'M NOT GOING TO
DISPUTE YOU ON THAT, JUDGE, BECAUSE YOU'RE READING IT PERFECTLY. CHIEF
JUSTICE RABNER: HOW DOES THAT WORK IN THE CASE OF A PHYSICIAN WHO'S PROVIDING MEDICAL
TREATMENT FOR AN INJURY THAT OCCURRED TWO AND A HALF YEARS AGO? APPELLANT:
THE LEGISLATURE DID NOT CONDUCT A CLASS IN MASTER DRAFTING OF LEGISLATION WHEN THEY AMENDED
SECTION 15. I CONCEDE THAT. THERE IS NOT A SPECIFIC PROVISION THAT SAYS DATE OF SERVICE.
BUT THAT'S WHY WE GO BACK TO JUDGE MARTINO'S DECISION. BECAUSE JUDGE MARTINO DID A VERY
CAREFULLY REASONED ANALYSIS OF HOW THE STATUTE SHOULD APPLY BECAUSE OF THE TIME PERIODS,
BECAUSE OF WHAT YOU JUST READ. THERE IS A CONCERN THAT IT DOESN'T SPECIFICALLY SAY DATE
OF SERVICE. SO WHAT JUDGE MARTINO DID WAS EQUATE THE DATE OF THE LOSS THAT THE MEDICAL
PROVIDER WOULD HAVE, WHICH IS THE DATE OF SERVICE, WITH THE DATE OF LOSS THAT THE
INJURED WORKER WOULD HAVE. JUSTICE ALBIN: THAT'S VERY NICE WHAT HE DSHGS
BUT THE QUESTION IS WHETHER OR NOT IT WAEL FOLLOWS FROM THE STATUTE. SO THE ONE THING
THAT IS CLEAR, 14-ONE HAS A SIX-YEAR STATUTE OF LIMITATIONS FOR ALL CONTRACT CLAIMS.
THAT INCLUDES CONTRACTS BETWEEN A PHYSICIAN AND A PATIENT. WHAT IS LESS THAN CLEAR,
UNLESS YOU CAN SHOW ME THE CLARITY, IS THE CLARITY IN 15-15 AND 15-51, THE CLARITY THAT
THERE IS A TWO-YEAR STATUTE OF LIMITATIONS NOW ON THOSE CLAIMS THAT ARE WORK RELATED.
WHERE IS THE CLARITY? APPELLANT: THERE ISN'T CLARITY. I CONCEDE THAT THERE'S
NOT CLARITY. THIS IS NOT A -- THIS IS NOT AS I SAID A MASTER -- OFRJTSR.
JUSTICE ALBIN: SO IN A LACK OF CLARITY, WHEN THERE'S ONE STATUTE THAT IS UN-QUESTIONABLY
CLEAR AND ANOTHER STATUTE THAT IS NOT SO, WHY WOULD WE UPEND THE CLEAR STATUTE FOR
SOMETHING THAT IS AMBIGUOUS? APPELLANT: BECAUSE THE CONTRACT STATUTE, THE
CONTRACT STATUTE OF LIMITATIONS APPLIES TO CONTRACTS. THESE ARE NOT CONTRACTS, BECAUSE
THE MEDICAL PROVIDERS ARE NOT TRYING TO ENFORCE A CONTRACT AGAINST A PETITIONER. THEY CANNOT.
JUSTICE PATTERSON: BUT THEY SAY, THE MEDICAL PROVIDER SAYS SOME OF THIS
IS CONTRACT. THEY'RE PPO ARRANGEMENTS, A VARIETY OF ARRANGEMENTS. WHAT'S YOUR RESPONSE
TO THAT? APPELLANT: THOSE CLAIMS -- THERE ARE -- LET ME TAKE A STEP BACK.
YES, THERE ARE PPO ARRANGEMENTS THAT ARE NETWORK PROVIDERS, HOWEVER YOU WANT TO DESCRIBE
IT. YES, THERE ARE CONTRACTS OUT THERE BETWEEN INSURANCE CARRIERS AND MEDICAL PROVIDERS.
BUT THOSE ARE NOT THE CLAIMS THAT ARE THE SUBJECT OF THE MEDICAL PROVIDER CLAIMS IN THE
DIVISION. THERE ARE CLAIMS THAT ARISE UNDER THESE AGREEMENTS AND USUALLY THOSE ARE BASED
ON CODING DISPUTES WHERE THE MEDICAL PROVIDER SAYS YOU SHOULD HAVE PAID ME 3,000 AND YOU
ONLY PAID ME 2,000 AND THEN THERE'S A COMPARISON OF THE CODES AND THAT'S ALL UNDER THE
CONTRACT. BUT THOSE CLAIMS DO COME UP IN THE DIVISION OF WORKER'S COMP. AS THEY SHOULD.
BUT THOSE ARE IN A SPECIFIC DATE OF SERVICE -- JUSTICE PATTERSON: THE ARGUMENT
BEING THAT -- THEIR ARGUMENT IS IT'S IN-CORRECT TO SAY THAT THIS IS DEVOID OF CONTRACTUAL
FEATURES BECAUSE THERE ARE CONTRACTUAL ORIGINS TO THESE CLAIMS. APPELLANT:
THERE ARE SOME CONTRACTUAL ORIGINS TO SOME OF THE CLAIMS. BUT THE CLAIMS THAT WE'RE FACING
IN THESE PARTICULAR CASES ARE BROUGHT BY MEDICAL PROVIDERS THAT ARE NOT UNDER CONTRACT.
THEY'RE NOT IN NETWORK. THEY OFTENTIMES REFUSE TO GO IN NETWORK BECAUSE THEY WANT TO
GET WHAT THEY WANT TO GET. IT'S ABOUT THE MONEY IN THAT CASE. JUSTICE ALBIN:
SO WHY -- SOMEHOW MISS TICK KELLY THESE CONTRACTS BETWEEN PATIENTS AND PHYSICIANS BECOME
SOMETHING OTHER THAN CONTRACTS. WHY SHOULDN'T WE CONSIDER THE DOCTORS WITHIN THE WORKER'S COMP
ARENA SHOULD BE THIRD PARTY BENEFICIARIES? THEY HAVE AN ORIGINAL CONTRACT WITH THE PATIENT.
WHEN IT'S WORK RELATED, THEY COME -- BECOME THIRD PARTY BENEFICIARIES AND THE WORKER'S
COMP CARRIER OR THE EMPLOYER IS NOW RESPONSIBLE FOR THE PAYMENT. WHY SHOULDN'T WE LEAVE
IT THAT WAY? APPELLANT: WELL, THEY'RE NOT WAEL A THIRD-PARTY BENEFICIARY
BECAUSE THERE'S NO CONTRACT TO WHICH THEY WOULD BE THE BENEFICIARY OF. I TRIED TO ARGUE
THIS IN THE APPELLATE DIVISION. THAT THE CONTRACT WE WOULD BE -- WE MEANING THE
INSURANCE CARRIER, WE WOULD BE THE BENEFICIARY OF THE CONTRACT BETWEEN THE MEDICAL PROVIDER
AND THE INJURED WORKER. AND THAT DOESN'T WORK. AND THE DOCTOR IS NOT A BENEFICIARY OF
A CONTRACT BETWEEN ANYBODY BECAUSE THERE IS NO CONTRACT. JUSTICE ALBIN:
WHEN THESE ARRANGEMENTS BETWEEN THE PHYSICIANS AND THE PATIENT BEGIN, DON'T THE PATIENTS
SIGN THINGS SAYING THAT I'M RESPONSIBLE FOR THIS? DON'T THEY SIGN SOME CONTRACTUAL FORMS?
APPELLANT: YES. THEY ABSOLUTELY DO. AND -- JUSTICE ALBIN:
SO ALL OF THESE START OUT AS CONTRACTS, NO? APPELLANT: THEY DO START OUT
AS CONTRACTS, YES. BUT LET ME TRY AND DRAW AN ANALOGY FOR YOU. IF A PERSON IS INJURED
IN A SUPERMARKET, THEY SLIP AND FALL IN THE AISLE OF A SUPERMARKET. THEY HAVE A TORT
CLAIM. THEY HAVE A TORT CLAIM WHERE THEY HAVE THE ABILITY TO SUE FOR PUNITIVE DAMAGES,
FOR COMPENSATORY DAMAGES, FOR PAIN AND SUFFERING. THE SUPERMARKET HAS DEFENSES, CONTRIBUTORY
NEGLIGENCE. BUT IF THAT PERSON IS AN EMPLOYEE OF THE SUPERMARKET AND IS INJURED IN THE
SAME KIND OF INSTANCE DURING THE COURSE OF THEIR EMPLOYMENT, THERE IS NO LONGER A TORT
LACHLT IT'S A WORK CLAIM. WHY? BECAUSE THE LEGISLATURE SAID SO. WHY OPERATION OF LAW,
THE TORT CLAIM IS NOW A WORKER'S COMP CLAIM. BY THE SAME ANALOGY, THE LEGISLATURE, WHEN
IT SAYS EXCLUSIVE JURISDICTION FOR THESE CONTRACTS OR THESE CLAIMS, WHAT HAVE YOU WANT
TO FASHION THEM AS IS WITHIN THE DIVISION OF WORKER'S COMP, THE LEGISLATURE EXTINGUISHED
THE CONTRACT CLAIM BECAUSE THE EMPLOYER IS STATUTORILY OBLIGATED TO PROVIDE TREATMENT
AND PAY FOR TREATMENT AS A RESULT OF A WORK-RELATED INJURY. JUSTICE
SOLOMON: IN FACT THE AMENDMENTS IN 2012 SPECIFICALLY SAY, DOCTOR, IF YOU WANT TO GET
PAID, YOU HAVE TO FILE IN COMP COURT, NOT SUPERIOR COURT. APPELLANT: EXACTLY.
JUSTICE SOLOMON: IT SPECIFICALLY SAYS THAT. SO STHE ANSWERED ALL THESE
CONTRACTUAL ISSUES, THESE JURISDICTIONAL ISSUES BY SAYING HOWEVER WE INTERPRET IT, WE
INTERPRET IT, BUT WHEN WE PROVIDE THAT TREATMENT TO YOU, YOU CAN CALL IT A CONTRACT BETWEEN
PATIENT AND DOCTOR, YOU CAN CALL IT A KWOM KWAUT, YOU BRING YOUR CLAIM IN THE COMP COURT,
NOWHERE ELSE. CORRECT? SO DOESN'T THAT ANSWER THE QUESTION? THE DOCTOR GETS PAID IF
THE COMP COURT SAYS IT'S WORK RELATED YOU GET PAID. APPELLANT: EXACTLY.
JUSTICE SOLOMON: AND TYPICALLY THE WORKER'S COMP STATUTE, DOESN'T THE STATUTE
SPECIFICALLY SAY, NOTWITHSTANDING THE AMBIGUITY OF THIS SECTION, THAT THE STATUTE OF
LIMITATIONS RUNS TWO YEARS FROM THE LAST PAYMENT. WHATEVER THE HECK THAT PAYMENT WAS.
APPELLANT: YES. JUSTICE SOLOMON: CORRECT? SO IF A MEDICAL
PROVIDER -- BY THE WAY, YOU MAY CORRECT ME ON THIS ONE, BUT THIS IS HOW I ALWAYS OPERATOR.
IF THE MEDICAL PROVIDER PROVIDES TREATMENT FOR FIVE YEARS FROM THE DATE OF THE ACCIDENT,
WORK-RELATED ACCIDENT, WORK-RELATED INJURY, BACK INJURY, STILL GETTING TREATMENT, FIVE
YEARS DOWN THE ROAD, AND IN FIVE YEARS, IN SIX YEARS TEN MONTHS, THEY HAVEN'T GOTTEN PAID.
THEY BRING THE CLAIM IN WORKER'S COMP COURT, CORRECT? APPELLANT: THEY CAN,
YES. JUSTICE SOLOMON: BECAUSE THE LAST PAYMENT, FIVE YEARS AFTER THE ACCIDENT
WAS WITHIN TWO YEARS OF THE CLAIM BEING MADE BY THE DOCTOR. APPELLANT: YES.
JUSTICE SOLOMON: SO THE AMBIGUITY WE HAVE TO DEAL WITH IS, WHAT DO WE DO
WHEN THERE'S A GAP BETWEEN LAST PAYMENT, I THINK, I MAY BE WRONG, PLEASE CORRECT ME, IF
YOU DON'T THEY WILL, THE LAST PAYMENT IS MADE MORE THAN TWO YEARS, IF THE LAST PAYMENT
IS MADE MORE THAN TWO YEARS BEFORE THE NEXT TREATMENT AND THE TREATMENT IS FOR THAT SAME
CONDITION, HOW DO THEY GET PAID FOR THAT? AND I THINK THAT'S KIND OF WHAT EVERYONE's
ASKING, BECAUSE YOU'VE GOT BAD BACK BECAUSE YOU LIFTED A BARREL AND YOU HURT IT DURING
WORK AND YOU'RE GETTING TREATED, TREATED, TREATED, AND EVERYTHING SEEMS OKAY AND MORE
THAN TWO YEARS AFTER YOUR LAST PAYMENT THERE'S AN AGGRAVATION CLEARLY RELATED TO THAT
ORIGINAL INJURY, HOW DOES THAT DOCTOR GET PAID? APPELLANT: IF HE FILES WITHIN
TWO YEARS OF THE -- JUSTICE SOLOMON: HE DIDN'T BECAUSE HE DIDN'T KNOW HE WAS
GOING TO TREAT IT WITHIN TWO YEARS. APPELLANT: AND HE DOESN'T GET PAID AT
ALL. JUSTICE SOLOMON: AT ALL. APPELLANT: NOW, I AGREE WITH
MOST OF WHAT YOU SAID THERE. JUSTICE SOLOMON: CORRECT ME. APPELLANT:
PART OF THE PROBLEM IN THIS CASE IS IF THERE'S OF COURSE -- NOT JUST THIS CASE BUT ALL
OF THESE CASES. IF THERE'S A COURSE OF ONGOING TREATMENT AND AS WAS POINTED OUT JUST
A FEW MOMENTS AGO IF THERE'S TREATMENT ON JANUARY 1ST AND JANUARY 10TH AND JANUARY 15TH, THAT
GIVES RISE, ACCORDING TO JUDGE MARTINO, EACH ONE GIVES RISE TO A SEPARATE CAUSE OF ACTION.
JUSTICE SOLOMON: THEORETICALLY IF THEY DON'T GET PAID. APPELLANT:
SO THE ONGOING TREATMENT AND THE PAYMENT OF THOSE ONGOING TREATMENTS AND THEN THE GAP
OF PAYMENTS I WOULD ARGUE DOES NOT NECESSARILY REVIVE THE ABILITY TO FILE A CLAIM FOR
THOSE EARLIER PAYMENTS. JUSTICE SOLOMON: WHERE DOES IT SAY THAT?
APPELLANT: IT DOESN'T. THAT'S WHAT JUDGE MARTINO SAID. JUSTICE SOLOMON:
I UNDERSTAND. APPELLANT: AND THE REASON HE SAID THAT, AND LET ME GO BACK
TO JUDGE MARTINO'S DECISION. THE JUDGE HANDLES THESE CASES, HE ADMINISTERS THESE KIND
OF CASES ALONG WITH THE THOUSANDS OF WORKER'S COMP CASES THAT HE DOES ON A DAILY BASIS.
SO HE HAD TO FIT THIS ANALYSIS INTO WHAT HE FACES EVERY DAY. SO WHEN HE ANALOGIZED THE
DATE OF SERVICE FOR EACH OF THE CLAIMS TO THE DATE WHEN THE CAUSE OF ACTION ACCRUES AND
BEING SIMILAR TO THE DATE OF THE ACCIDENT, HE DID SO FOR A REASON, SO THAT THERE WOULD
BE A DATE CERTAIN THAT EVERYBODY KNEW ABOUT, THE DOCTOR KNEW ABOUT, THE RESPONDENT KNEW
ABOUT IT, THE EMPLOYER RESPONDENT KNEW. SO THERE WOULD BE A FIXED DATE FOR EACH OF THE
CLAIMS FOR WHICH EVERYBODY KNEW THE CLAIM HAD TO BE FILED. JUSTICE SOLOMON:
CORRECT ME. I ALWAYS THOUGHT YOU CAN MAKE A MAKE FOR COMP WITHIN TWO YEARS OF THE LAST
PAYMENT. APPELLANT: YES. THE INJURED WORKER. JUSTICE SOLOMON:
THE LAST PAYMENT WAS ANY PAYMENT. APPELLANT: YES. JUSTICE SOLOMON:
SO IF THE INJURED WORKER -- IF THIS ISN'T ANSWERED CLEARLY IN THE STATUTE, WE'RE GOING
TO HAVE TO FIGURE IT OUT. IF THE INJURED WORKER WOULD HAVE A CLAIM FOR TREATMENT FROM
THAT DOCTOR BECAUSE THE LAST TREATMENT OR PARTIAL PAYMENT HE RECEIVED WAS WITHIN TWO YEARS,
WHY COULDN'T THAT DOCTOR GO INTO COMP COURT AND SAY THE LAST PAYMENT WAS -- FOR ANYTHING
WAS LESS THAN TWO YEARS AGO, WE HAVE A CLAIM FOR NEW MEDICAL TREATMENT? WHY COULDN'T
THAT DOCTOR DO THAT? WHAT TELLS US WE CAN'T? APPELLANT: IF THE WORKER IS
WITHIN TWO YEARS, THE DOCTOR IS GOING TO BE WITHIN TWO YEARS. UNLESS I'M
MISUNDERSTANDING YOUR PREMISE. JUSTICE SOLOMON: NO, YOU'RE NOT. THE LAST
PAYMENT. DR. X GAVE HIM A SOMETHING TREATMENT WITHIN TWO YEARS. DOCTOR Y NOW GIVES HIM
ANOTHER BUT RELATED TREATMENT WITHIN TWO YEARS OF THAT DR. X's TREATMENT. HE'S GOT A
CLAIM IN COMP COURT. APPELLANT: DR. Y DEFINITELY DOES. DR. Q MAY NOT.
JUSTICE SOLOMON: UNLESS WE SAY HE DOES. APPELLANT: LET'S USE SOME DATES.
LET'S SAY DR. X TREATED ON DECEMBER 1ST, 2017, DR. Y TREATED ON JANUARY 1ST, 2018. AND
DR. X, THE FIRST DOCTOR DOESN'T FILE HIS CLAIM WITHIN TWO YEARS OF DECEMBER 1ST, 2017.
JUSTICE SOLOMON: HOW DOES THAT MAKE SENSE THOUGH? WHERE DOES IT SAY THAT
IN THE STATUTE? APPELLANT: BECAUSE THAT'S WHAT THE TWO-YEAR STATUTE OF
LIMITATIONS IS SUPPOSED TO GOVERN. JUST LIKE THE PETITIONER. IF THE PETITIONER HAD ONLY
TREATED WITH DR. X ON 2017 HE WOULD BE BARRED. JUSTICE SOLOMON: DECEMBER
31ST, 2019, HE WOULDN'T BE. APPELLANT: THAT'S CORRECT. BUT THE SAME
RULES FOR FILING HAVE TO APPLY TO BOTH -- JUSTICE SOLOMON: OKAY. MAYBE I'M
NOT BEING UNDERSTOOD. THIS IS MY POINT. APPELLANT: IT COULD BE ME.
JUSTICE SOLOMON: THAT'S OKAY. I'M NOT ALWAYS THAT CLEAR. JUST ASK ANYBODY IN THIS COURT
OR IN MY FAMILY. JUSTICE PATTERSON: NO COMMENT. JUSTICE SOLOMON:
YOU HAVE THE RIGHT TO REMAIN SILENT. IF TWO YEARS FROM THE LAST PAYMENT IS
TWO YEARS FROM THE LAST PAYMENT OF ANY KIND, THEN THE PETITIONER, LAST PAYMENT IN COMP,
THE PETITIONER HAS A RIGHT TO MAKE A CLAIM WITHIN TWO YEARS OF THE LAST MEDICAL PAYMENT
BY THE INSURANCE CARRIER FOR ANY DOCTOR, ANY PARTIAL SDABLT. APPELLANT:
THAT'S CORRECT. JUSTICE SOLOMON: NOW HE GOES BACK TO A DIFFERENT DOCTOR WITHIN
TWO YEARS AND THAT DOCTOR IS TREATING THAT CONDITION AND IT'S CLEARLY WORK RELATED.
IF THE PETITIONER CAN MAKE THE APPLICATION FOR THAT PAYMENT OF THAT BILL BY A DIFFERENT
DOCTOR, WHY SHOULD NOT THAT DIFFERENT DOCTOR BE ABLE TO MAKE THAT SAME CLAIM? WHERE DOES
IT SAY YOU CAN'T? APPELLANT: THE DIFFERENT DOCTOR CAN, BUT THE FIRST DOCTOR
CANNOT IF HE DOESN'T FILE WITHIN TWO YEARS. JUSTICE SOLOMON: UNDERSTOOD.
APPELLANT: SO I AGREE. THE DIFFERENT DOCTOR CAN FILE -- JUSTICE
SOLOMON: OKAY. SO I MISUNDERSTOOD YOUR ANSWER, WHICH WAS PROBABLY A LOT MORE SIMPLE THAN
MY QUESTION. BUT THAT WAS WHAT I ALWAYS UNDERSTOOD THE CURRENT STATUS OF COMP LAW,
THE CURRENT STATUTE OF LIMITATIONS UNDER COMP LAW AND THE DIFFERENCE IS, THE ONLY DIFFERENCE
IS UNDER THE '12 STATUTE, 2012, THE DOCTOR CAN ONLY SUE UNDER THE WORKER'S COMP STATUTE
AS AMENDED. APPELLANT: YES FOR WORK-RELATED INJURIES. JUSTICE
SOLOMON: EXACTLY. AND HIS CLAIM IS BOUND BY THE SAME STATUTE OF LIMITATIONS THAT THE
PETITIONER IS BOUND BY. THAT'S YOUR ARGUMENT. APPELLANT: YES, THAT'S MY
ARGUMENT. CHIEF JUSTICE RABNER: THAT WHOLE BACK AND FORTH THAT WE JUST HEARD
IS DIFFERENT IF IT'S A DENIAL. APPELLANT: IF A DENIED CLAIM -- IF IT'S A
DENIED CLAIM, YES. CHIEF JUSTICE RABNER: THEN YOU HAVE TO LOOK BACK UNDER
THE PLAIN LANGUAGE OF THE STATUTE TO THE DATE ON WHICH THE ACCIDENT OCCURRED.
APPELLANT: I WOULD DISAGREE. BECAUSE, AS YOU POINTED OUT EARLIER, IF IT'S A DENIED CLAIM
AND NOBODY FILES A CLAIM PETITION AND THEY WANT TO FILE A CLAIM, THEY HAVE TO BRING IN
PROOFS TO ESTABLISH THEIR CAUSE OF ACTION. AND THEIR CAUSE OF ACTION CANNOT ACCRUE UNTIL
THEY HAVE PROVIDED TREATMENT. JUSTICE ALBIN: AND ALL THESE ARGUMENTS THAT
I'M HEARING WOULD BE TOTALLY UN- NECESSARY IF WE JUST APPLY 14-ONE, THE CONTRACT PROVISION
THAT HAS SEEMINGLY ALWAYS GOVERNED THIS. AND YOUR ARGUMENT, IT SEEMS, HAS TO BE MERELY
BECAUSE 15-ONE SAYS THAT WORKER'S COMP HAS EXCLUSIVE JURISDICTION THAT SOMEHOW
IMPLICITLY THE LEGISLATURE INTENDED TO COMPLETE ABROGATE THE TYPICAL STATUTE OF LIMITATIONS
THAT WOULD GOVERN. RIGHT? APPELLANT: YESSISH, JUDGE. LET ME TRY TO
EXPLAIN MY EQUIVOCATION THERE. WITH A SIX-YEAR STATUTE OF LIMITATION FOR CONTRACTS HAS
NEVER APPLIED IN THE DIVISION OF WORKERS COMPENSATION. SIX YEARS IS NOT MENTIONED
ANYWHERE IN THE STATUTE. THE LEGISLATURE WHEN IT DRAFTED THE WORKER'S COMP ABILITYR ABILITY
ONLY PUT IN TWO YEARS FOR ALL CLAIMS. IF YOU'RE A PIP CARRIER, IF YOU ARE A DEPENDENT
SPOUSE SEEKING REIMBURSEMENT FOR THE DEATH OF YOUR SPOUSE, A DEPENDENT CHILD. THE ESTATE.
EVERYBODY HAS TWO YEARS AND TWO YEARS ONLY. THERE'S NO PLACE IN THE STATUTE THAT YOU CAN
FIND A REFERENCE TO SIX YEARS. AND I DO WANT TO POINT OUT TO THE COURT THAT
THE DECISION IN CHRISTODOULOU ACTUALLY SHOWS THAT THE SIX YEARS WAS NOT APPLIED IN THAT
CASE. I WON'T BORE THE COURT WITH ALL OF THE DETAILS OF CHRISTODOULOU. BUT ONE OF THE
MOST IMPORTANT ASPECTS OF CHRISTODOULOU FOR PURPOSES OF TODAY IS THAT IN CHRISTODOULOU
THE MEDICAL PROVIDER IN THAT CASE PROVIDED TREATMENT TO THE DECEASED WORKER BEFORE HE
DIED. AND THEN PRESENTED ITS BILLS AS PART OF THE PROPOSED WORKER'S COMP CONVERSE
COMPENSATION CLAIM THAT THE PETITIONER HAD FILED. THEY DID NOT FILE A CLAIM PETITION.
THE DEATH OCCURRED IN 1996. IT WAS REPRESENTED TRO THE MEDICAL PROVIDER THAT THEIR BILLS
WOULD BE TAKEN CARE OF. SURPRISINGLY THEY WEREN'T. THEY SECTION 20ED THE CASE FOR
$50,000 KNOWING THERE WAS $700,000 IN MEDICAL BILLS OUT THERE. THE MEDICAL
PROVIDER WAS SHOCKED, AS YOU MIGHT BE, WHEN THEIR BILLS WEREN'T TAKEN CARE OF WHEN THEY WERE
PROMISED TO BE TAKEN CARE OF AND THEY WANTED TO BE PAID. IN 2000, WHICH IS FOUR YEARS
AFTER THE DEATH AND FOUR YEARS AFTER THE DATE OF SERVICE, THEY FILED A MOTION TO VACATE
THE SECTION 20 AND THEY FILED A MOTION IN THE DIVISION SEEKING TO PRESENT THEIR BILLS.
AS A MEDICAL PROVIDER SEEKING REIMBURSEMENT. THE APPELLATE DIVISION DENIED THOSE MOTIONS.
THE APPELLATE DIVISION -- I'M SORRY. THE DIVISION OF WORKERS COMPENSATION DENIED THOSE
MOTIONS. THE APPELLATE DIVISION AFFIRMED THAT DENIAL. JUSTICE ALBIN: WAIT.
CHRISTODOULOU? APPELLANT: CHRISTODOULOU. NOW THIS IS THE ORIGINAL CASE
FILED -- JUSTICE ALBIN: ARE YOU TALKING ABOUT THE CHRISTODOULOU THAT WE
HANDLED? APPELLANT: YES. NOW THE MAIN CASE ARISING OUT OF THE CIVIL CASE
AND THAT'S WHERE -- JUSTICE ALBIN: I'M A LITTLE FAMILIAR WITH IT.
APPELLANT: I THOUGHT THAT YOU MIGHT BE. AS I RECALL YOU HAD A LABORING HAND IN THAT ONE.
JUSTICE ALBIN: SO IN THAT CASE THE MEDICAL PROVIDER WAS KEPT OUT OF THE
WORKERS KOFRM -- THEY THOUGHT THEY WERE GOING TO GET PAID AND THEY SETTLED FROM UNDER
THEM AND WHAT THEY DID WAS SAY LET'S FILE IN THE LAW DIVISION. APPELLANT:
THEY DID BUT -- JUSTICE ALBIN: AND WE SAID NOTHING WRONG WITH THAT SINCE
THEY WERE NOT APPRISED OF WHAT WAS GOING ON IN THE WORKER'S COMP COURT.
APPELLANT: ABSOLUTELY. THAT'S EXACTLY WHAT YOU SAID IN CHRISTODOULOU, THE REPORTED DIVISION.
JUSTICE PATTERSON: BUT YOUR CONTENTION IS THAT THE 2012 AMENDMENTS
CHANGED ALL THAT. APPELLANT: YES. I'M NOT SURE CHRISTODOULOU WOULD BE DECIDED
THE SAME WAY TODAY. BUT WHAT I WANTED TO POINT OUT TO JUSTICE ALBIN AND TO THE COURT
IS THAT IF YOU REVIEW THE PROCEDURAL HISTORY, WHAT HAPPENED BEFORE THE CIVIL ACTION WAS
THEY FILED IN THE DIVISION AND THE DIVISION DENIED THEIR MOTION BECAUSE IT WAS FILED FOUR
YEARS AFTER THE DATE OF SERVICE. JUSTICE ALBIN: AND DESPITE THE FACT THAT
IT WAS SO-CALLED WORK RELATED, THEY STILL WERE ABLE TO FILE IN THE LAW DIVISION --
APPELLANT: AT THAT TIME. BECAUSE THERE WAS NO AMENDMENT TO SECTION 15. THAT AMENDMENT
DIDN'T TAKE PLACE UNTIL EIGHT YEARS LATER. CHIEF JUSTICE RABNER: TO BE CLEAR
THEN, PRIOR TO 2012, HOW LONG DID A MEDICAL SERVICE PROVIDER HAVE TO PURSUE THE CLAIM?
APPELLANT: WELL, IT'S NOT AN EASY ANSWER, BECAUSE THERE IS A CONTRACT CLAIM
FOR 2012 AND THE CONTRACT CLAIM AGAINST THE INJURED WORKER LASTED SIX YEARS. THAT'S THE
TIME PERIOD WITHIN WHICH THEY COULD FILE. HOWEVER, AND I KNOW THIS FIRSTHAND BECAUSE
I DID THIS A LOT, IF THERE WAS A PENDING WORKERS COMPENSATION CLAIM, WE WOULD FILE A MOTION
TO TRANSFER ANY CONTRACT CLAIM TO THE DIVISION OF WORKERS COMPENSATION. AND I'D LIKE
TO SAY I'M 100 PERCENT PERFECT ON MY RECORD OF GETTING THAT TO HAPPEN BECAUSE THE SUPERIOR
COURT RECOGNIZED THAT THESE WERE WORK-RELATED INJURIES THAT SHOULD BE HANDLED IN THE
DIVISION. SO WHAT HAPPENED AS A MATTER OF PRACTICE WAS THAT THESE CONTRACT CLAIMS BY
MEDICAL PROVIDERS IN WORKERS COMPENSATION CASES WERE TRANSFERRED TO THE DIVISION TO BE
HANDLED THERE. THE ANSWER TO YOUR QUESTION IS SIX YEARS. JUSTICE
FERNANDEZ-VINA: IT REMAINS SIX YEARS. APPELLANT: IT WAS SIX YEARS FROM THE
CONTRACT CLAIM BETWEEN THE MEDICAL PROVIDER -- JUSTICE FERNANDEZ-VINA: SO
THE TRANSFER AFFECTED THEIR VENUE NOT THE STATUTE OF LIMITATIONS? APPELLANT:
WELL, TECHNICALLY, YES. JUSTICE FERNANDEZ-VINA: NOT TECHNICALLY. YES.
APPELLANT: WELL, IF YOU READ THE PROCEDURAL HISTORY IN CHRISTODOULOU, THAT'S
NOT IN PRACTICE WHAT WAS BEING DONE. JUSTICE ALBIN: BUT THAT'S PRECISELY
WHAT WE SAID. WE SAID THAT WHEN THERE IS AN ACTIVE WORKER'S COMP CASE AND THERE IS A
WORK RELATED CONTRACT CLAIM BROUGHT BY A MEDICAL PROVIDER IN THE LAW DIVISION, WE SHOULD
TRANSFER -- WE SAID THOSE CASES SHOULD BE TRANSFERRED TO THE WORKER'S COMP COURT. WE
DIDN'T SAY THAT IF THE MEDICAL PROVIDER FILED THREE OR FOUR YEARS AFTERWARDS THAT THAT
CLAIM WAS GOING TO BE EXTINGUISHED. ALL WE SAID WAS THAT THEY SHOULD BE TRANSFERRED,
CORRECT? APPELLANT: YOU DIDN'T SAY THAT IN THE CHRISTODOULOU FROM THE SUPERIOR
COURT. BUT WHEN YOU DENIED CERTIFICATION OF THE APPELLATE DIVISION's AFFIRMANCE OF THE
DISMISSAL OF THE CLAIM PETITION L FILED BY THE MEDICAL PROVIDER, YOU DID. CHIEF
JUSTICE RABNER: I'M AFRAID WE DON'T READ CERT DENIALS THAT THAT WAY.
APPELLANT: WELL, I TRIKE TO TRY TO BE CREATIVE WHEN I RAISE THESE PROCEDURAL HISTORIES.
BUT I THINK THAT IT STANDS FOR THAT PROPOSITION. IF YOU REALLY LOOK AT THE PROCEDURAL
HISTORY AND WHAT HAPPENED, SIX YEARS HAS NEVER BEEN APPLIED IN THE DIVISION OF WORKERS
COMPENSATION. CHIEF JUSTICE RABNER: HERE'S THE QUESTION I WANTED TO GET
AT. PRE-2012, A DOCTOR HAD SIX YEARS. APPELLANT: TO FILE AGAINST A WORKER.
CHIEF JUSTICE RABNER: 2012 THE LANGUAGE IS. APPELLANT: RIGHT.
CHIEF JUSTICE RABNER: THERE'S NO SXEFD STATEMENT IN THE LEGISLATIVE HISTORY
OR TELL US IF THERE IS THAT ADJUSTS THE STATUTE OF LIMITATIONS OR ADDRESSES THE STATUTE OF
LIMITATIONS EXPRESSED STATEMENT. APPELLANT: THAT'S A CORRECT STATEMENT.
THERE IS NOTHING IN THE STATUTE. THERE'S NOTHING IN THE LEGISLATIVE HISTORY THAT ADDRESSES
THE STATUTE OF LIMITATIONS FOR FILING. BUT WHAT I WOULD POINT THE COURT TO IS THE FACT
THAT THE LEGISLATURE CONTEMPLATED PUTTING IN SEPARATE PROCEDURES AND ELECTED NOT TO DO
SO BECAUSE THEY FOUND THAT THE PROCEDURES AND THE RULES IN PLACE WERE EFFECTIVE TO HANDLE
THE MEDICAL PROVIDER CLAIMS. JUSTICE PATTERSON: BUT THE PROCEDURES IN
THAT SETTING MEAN STATUTE OF LIMITATIONS? APPELLANT: I THINK THAT IT HAS
TO, JUDGE, BECAUSE IT'S A JURISDICTIONAL THING. YOU HAVE TO FILE WITHIN THE JURISDICTION
OF THE DIVISION GRANTED. JUSTICE ALBIN: I THOUGHT THE PROCEDURES WAS IN
REFERENCE TO POTENTIAL ARBITRATION PROCEEDINGS THAT WOULD HAVE BEEN IMPOSED UPON PHYSICIANS?
APPELLANT: THAT WAS ONE OF THE THINGS CONTEMPLATED. JUSTICE
ALBIN: THAT WAS EXPLICIT. APPELLANT: IT WAS. I'M NOT DENYING IT. IT WAS.
ARBITRATION WAS CONTEMPLATED. I BELIEVE DISCOVERY -- ADDITIONAL DISCOVERY --
JUSTICE ALBIN: WUNG THAT ARBITRATION WAS EXPLICIT. WHERE WAS THE STATUTE OF
LIMITATIONS EXPLICIT IN THE LEGISLATIVE HISTORY? APPELLANT: AGAIN, IT'S NOT.
JUSTICE ALBIN: THERE'S NO MENTION OF IT. APPELLANT: IT'S NOT.
BUT THE STATUTE OF LIMITATIONS THAT IS IN THE STATUTE WASN'T CHANGED BY THE AMENDMENT
TO SECTION 12. JUSTICE SOLOMON: IS ONE OF YOUR ARGUMENTS THAT IF THE DOCTOR
GIVES TREATMENT FOR THE WORK-RELATED INJURY, THE SUPERIOR COURT -- BECAUSE OF THE 2012
AMENDMENTS, THEY NO LONGER HAVE JURISDICTION TO ADJUDICATE THAT CLAIM?
APPELLANT: YES. JUSTICE SOLOMON: THAT CLAIM WOULD HAVE TO BE BROUGHT IN WORK
COURT? APPELLANT: YES. JUSTICE SOLOMON: I GUESS YOUR SECOND
ARGUMENT IS, IF IT'S BROUGHT IN WORKER'S COMP, THE WORKER'S COMP STATUTE CONTROLS.
APPELLANT: YES. JUSTICE SOLOMON: OKAY. SO THERE'S NO MENTION OF STATUTE OF
LIMITATIONS, BUT THERE IS MENTION OF JURISDICTION. APPELLANT: YES.
JUSTICE SOLOMON: WOULD YOUR ARGUMENT LIKEWISE BE THAT IF THIS CLAIM MORE THAN TWO YEARS
AFTER THE LAST DATE OF TREATMENT OR IF NO TREATMENT DENIED CLAIM MORE THAN TWO YEARS
AFTER THE ACCIDENT IS BROUGHT IN SUPERIOR COURT IT WOULD SIMPLY BE DISMISSED?
APPELLANT: YES. JUSTICE SOLOMON: WITH PREJUDICE. APPELLANT:
BECAUSE THERE'S NO BASIS -- JUSTICE SOLOMON: THERE'S NO JURISDICTION.
THE LEGISLATURE SAID THAT. APPELLANT: EXACTLY. IF IT'S A NON-WORK --
JUSTICE SOLOMON: IF I CARRY THAT TO ITS CONCLUSION LOGICALLY YOU'RE ASKING US TO
CONCLUDE THAT THE WORKER'S COMP STATUTE OF LIMITATIONS APPLIES, NOT THE LAW OF CONTRACT,
WHICH WOULD BE SIX YEARS BROUGHT IN SUPERIOR COURT RATHER THAN -- OTHERWISE IT WOULD HAVE
TO BE SIX YEARS IN WORKER'S COMP COURT, WOULD IT NOT? IF WE DECIDED THAT THE CONTRACT
CLAIM PERSISTS AND APPLIED A SIX-YEAR STATUTE OF LIMITATIONS, THE 2012 AMENDMENT IS REQUIRING
A CONTRACT CLAIM BE BROUGHT IN COMP COURT WITHIN SIX YEARS, NOT UNDER THE COMP STATUTE OF
LIMITATIONS BUT UNDER THE CONTRACT STATUTE OF LIMITATIONS. APPELLANT: THAT'S
THE ARGUMENT THAT THE MEDICAL PROVIDERS ARE MAKING, YES. JUSTICE SOLOMON:
IS ANYBODY DISPUTING -- I DIDN'T -- I COULDN'T REALLY TELL SO MAYBE THEY SHOULD ANSWER
THE QUESTION. IS ANYBODY DISPUTING THAT THE CLAIM's GOT TO BE BROUGHT IN WORKER'S COMP
COURT? APPELLANT: I DON'T BELIEVE SO BUT I'LL DEFER TO THEM FOR THEIR POSITION
ON THAT. BUT I WANT TO GET BACK TO -- AND YOU RAISED AN IMPORTANT QUESTION.
JUSTICE SOLOMON: ONCE IN AWHILE. APPELLANT: THE NATURE OF THESE CLAIMS ARE
NOT CONTRACT CLAIMS. THAT'S THE CONFUSING PART HERE. CHIEF JUSTICE RABNER:
I THINK WE UNDERSTAND YOUR POSITION ON THAT. I WANT TO GIVE YOUR FRIENDS A CHANCE TO
-- APPELLANT: I DON'T LIKE TO HOG ALL OF THE TIME. MOST OF IT BUT NOT ALL
OF IT. CHIEF JUSTICE RABNER: WE'LL HAVE YOU BACK FOR REBUTTAL.
APPELLANT: THANK YOU, JUDGE. APPELLANT1: MAY IT PLEASE THE COURT, I ADOPT
THE ARGUMENTS OF COUNSEL AND I DO WANT TO ADDRESS THE ISSUE OF THE FIRST VISIT TO THE
DOCTOR. IT IS MY EXPERIENCE THAT THE DOCTOR'S BILLING DEPARTMENT IS CONTACTING THE EMPLOYER
AND SEEKING THE NAME OF THE COMPENSATION CARRIER AND THE RELATIONSHIP DEVELOPS FROM THAT.
AND SPECIFICALLY IN THE CASES BEFORE THE COURT, THERE WAS AN ONGOING RELATIONSHIP BETWEEN
THE CARRIER AND THE DOCTOR. IN THE PARTICULAR CASE OF PARIS, THE DOCTOR WAS AUTHORIZED
BY THE CARRIER, SO THE WORKER IS NOT GOING INTO THAT DOCTOR AND SAYING PLEASE PROVIDE
ME TREATMENT AND I'LL SIGN A CONTRACT. THE WORKER UNDER THE WORKERS COMPENSATION ACT
IS DIRECTED TO THAT DOCTOR. AND THE DOCTOR IS -- EITHER HAS IMMEDIATE CONTACT -- HAS
HAD CONTACT WITH THE CARRIER TO ACCEPT THE PATIENT FOR TREATMENT AND KNOWS THEN AND
THERE THAT THE PAYMENT IS COMING UNDER THE WORKERS COMPENSATION ACT THAT IT'S THE CARRIER
THAT WILL BE PAYING AND THERE IS NO DIRECT CONTRACT WITH THE EMPLOYEE.
JUSTICE ALBIN: LET'S SAY THE CARRIER DOESN'T DIRECT. THE EMPLOYEE GOES TO THE DOCTOR
AND IN GOOD FAITH THE DOCTOR THINKS, THIS DOESN'T SEEM TO BE A WORK-RELATED INJURY AND
TREATS THE PERSON AND THEN LATER ON THE EMPLOYEE BRINGS A WORKER'S COMP ACTION. AND NOW
THE BILLING IS THREE YEARS OUT. AND THE DOCTOR IS NOW ATTEMPTING TO BRING THE -- HIS
OR HER CLAIM IN WORKER'S COMP THREE YEARS LATER. APPELLANT1: THERE ARE
SAFEGUARDS. JUSTICE ALBIN: UNDER YOUR INTERPRETATION, IS THE DOCTOR UNDER
THE STATUTE OF LIMITATIONS BRINGING THE CLAIM THREE YEARS AFTERWARDS, HAVING IN GOOD FAITH
NIELD THE LAW DIVISION? APPELLANT1: WELL, PRESENTLY THE DOCTOR WOULD NOT
BE SUCCESSFUL IN THE LAW DIVISION UNDER THE 2012 AMENDMENT. BUT THE DOCTOR WOULD HAVE
DUE DILIGENCE WHEN TAKING ON A PATIENT TO ASCERTAIN WHO HE'S BILLING. IS HE BILLING A
PRIET PLAN? IS HE BILLING MEDICAID? IS IT A WORK RELATED. THE DOCTOR ALWAYS TAKES A
HISTORY OF HOW THE ACCIDENT OCCURRED. AND THE DOCTOR IS COMMENTING ALMOST ALWAYS ON WHETHER
OR NOT IT'S A WORK-RELATED INJURY AND THE BILLING DEPARTMENT IS FOLLOWING UP. AND A HEALTHCARE
-- IF IT WAS A PRIVATE HEALTHCARE PROVIDER, YOU'D SEE THE LETTERS GOING OUT TO THE WORKERS
SAYING WAS THIS WORK RELATED BECAUSE THE PRIVATE HEALTHCARE CARRIER WANTS TO KNOW WHETHER OR
NOT TO TRANSFER TO THE COMP CARRIER. SO THERE ARE ACTIONS ON THE PART OF A
PHYSICIAN, EITHER THE WORKER IS BEING SENT TO THAT PHYSICIAN AND HE KNOWS WHERE HIS MONEY
IS COMING FROM OR HE HAS TO TAKE SOME DUE DILIGENCE ON HIS PART. JUSTICE
ALBIN: SOMETIMES PEOPLE WIND UP GETTING MEDICAL TREATMENT BEFORE ALL THIS INSURANCE STUFF
IS FIGURED OUT. SO THE PATIENT IS TREATED AND, YOU KNOW, MAYBE THE WORKER'S COMP CARRIER
IS GOING TO SAY, I'M NOT PAYING THAT. THEY CONTACT THEM. I'M SURE THAT SCENARIO --
APPELLANT1: THAT'S ANSWERING YOUR HONOR's QUESTION. IF YOU'RE SAYING HOW
WOULD THE DOCTOR KNOW HOW TO BILL, IF THE DOCTOR HEARS FROM THE COMP CARRIER THAT IT'S
DENIED CLAIM, THEN UNDER THE 2012 AMENDMENT, THE DOCTOR SHOULD BE FILING WITHIN TWO YEARS
OF HIS SERVICE. JUSTICE SOLOMON: IN COMP COURT. APPELLANT1:
IN COMP COURT. JUSTICE ALBIN: WHY SHOULD HE BE FILING IN COMP COURT.
APPELLANT1: IF HE WANTS THE COMP CARRIER TO PAY. JUSTICE ALBIN: WHY CAN'T
HE FILE IN THE LAW DIVISION? HE'S GOT A CONTRACT WITH THE PATIENT. THE PATIENT HAS A
CONTRACT FOR HIS SERVICES. SO THE DOCTOR HAS FIXED -- APPELLANT1: WELL,
HE'S NOT FORECLOSED. HE CAN FILE IF HE'S SAYING THAT HIS CONTRACT IS WITH THE INJURED
WORKER. HE CAN FILE. THE 2012 AMENDMENT DID NOT TAKE THAT AWAY FROM THE DOCTOR. YOU'RE
SAYING THE DOCTOR DOESN'T KNOW THAT IT'S WORK RELATED. THE DOCTOR DOESN'T BELIEVE THAT
IT'S WORK RELATED. AND THE DOCTOR DIDN'T GET PAID AFTER THREE YEARS. OF COURSE HE CAN
GO INTO SUPERIOR COURT AND FILE. HE'S SAYING IT'S NOT WORK RELATED. JUSTICE
SOLOMON: IN THAT CASE THE INSURANCE COMPANY THAT GOT BILLED OR THE CLIENT WHO GOT BILLED
WOULD CLAIM IT IS WORK RELATED AND THEY'D LITIGATE THAT IN SUPERIOR COURT AND SUPERIOR
COURT EITHER TRANSFER IT OR DIDN'T, IF THAT GOT LITIGATED. SOMEBODY WOULD HAVE TO DETERMINE
IF IT WAS WORK RELATED. IF IT IS WORK RELATED IT GETS DEALT WITH IN COMP COURT. IN OTHER
WORDS, IT WORKS THE WAY ANY OTHER INSURANCE BILLING WORKS. APPELLANT1: IF
THE DOCTOR IS SAYING IT'S NOT WORK RELATED, THERE WOULD BE NO EVIDENCE IN SUPERIOR COURT
THAT IT WAS WORK RELATED. JUSTICE ALBIN: LOOK. THE DOCTOR ISN'T IN THE
WORKPLACE. THE ONLY THING THE DOCTOR KNOWS IS WHATEVER INFORMATION IS RELATED. INFORMATION
COULD BE RELATED BY THE PATIENT. THE COMP CARRIER CAN SAY, I DON'T THINK THAT'S WORK
RELATED. YOU'RE ON YOUR OWN. BUT LATER THE WORKER CAN FILE A COMP CLAIM AND MAYBE THE
WORKER'S COMP WILL SAY THIS IS A COMP CLAIM AND THEN THREE YEARS HAS PASSED AND YOU'RE
SAYING WHAT THE DOCTOR NOW NO LONGER HAS A VIABLE OPTION FORGETTING PAID?
APPELLANT1: IN THE WORKERS COMPENSATION WORLD, IT IS THE CARRIER WHO'S DIRECTING TREATMENT.
YOU'RE PICKING A SCENARIO THAT IS JUST NOT THE COMMON ASPECT OF WORKER'S COMP. AND I
ALSO BELIEVE THAT IF THE DOCTOR TREATED -- YOU'RE SAYING ONLY ONE TIME AND THREE YEARS
LATER HE NEVER FILED -- HE NEVER FILED FOR PAYMENT IS WHAT YOU'RE SAYING. I THINK THAT
WHAT THE AMENDMENT IS -- JUSTICE ALBIN: HE CAN SEND BILLS OUT. HE'S JUST
NOT GETTING PAID BY MAYBE SENDING THEM TO THE PATIENT. NOT GETTING PAID.
APPELLANT1: IF BRINGING A CLAIM PETITION, THE EMPLOYEE WOULD PLACE ON THE CLAIM PETITION
ALL PROVIDERS. SO THE CARRIER WOULD HAVE NOTICE OF THE PROVIDER. THE CARRIER REACHES
OUT AND ATTEMPTS TO SECURE RECORDS AND THEN THE BILL IS SENT TO THE CARRIER. THERE ARE
MECHANISMS IN PLACE. AND THE COMP ACT IS FOR THE PURPOSE OF PROVIDING BENEFITS TO THE
EMPLOYEE. AND BRINGING THIS INTO THE COMP ACT IS FOR THE BENEFIT OF THE EMPLOYEE. RESOLVING
THESE DISPUTES IF WORK RELATED SO THAT A DOCTOR IS NOT THEN GOING -- SEEKING A COLLECTION
AGAINST THE EMPLOYEE IS FOR THE BENEFIT OF THE EMPLOYEE. CHIEF JUSTICE RABNER:
MS. LAMB, WHAT ELSE WOULD YOU LIKE TO TELL US? WE'RE ALMOST DONE WITH YOUR TEN MINUTES,
BELIEVE THE APPELLANT: : MAY IT PLEASE THE COURT I WILL TRY TO BE
BRIEF AND I DO INCORPORATE TO MY COLLEAGUES PRESENTATIONS BEFORE THIS COURT.
BUT I DID WANT TO ADDRESS THE QUESTION OF THE TWO YEARS. THE LEGISLATURE
IN 2012, NOT ONLY SAID EXCLUSIVE JURISDICTION WAS IN THE DIVISION BUT IT ALSO
SAID AND YOU CANNOT BALANCE BILL THE PLEA. OR THE INJURED WORKER OR YOUR
PATIENT. SO YOU KNOW, IN THIS COURT'S DECISION IN CHRISTODOULOU YOU MASS CASE,
THE COURT RECOGNIZED THERE WERE TWO SEPARATE CAUSES OF ACTION. THERE'S
THE CONTRACTUAL ACTION BETWEEN THE PHYSICIAN AND THE PATIENT AND THEN THERE IS
A SEPARATELY CREATED STATUTORY ACTION BETWEEN THE PHYSICIAN AND THE
EMPLOYER, THE PAYER THE EMPLOYER'S INSURANCE COMPANY THOSE ARE TWO SEPARATE TYPES
OF ACTIONS IN 2012, AND THIS COURT COMMENTED ON THE FACT THAT THE ACT DID NOT
NULLIFY THE CONTRACTUAL ARRANGEMENT BETWEEN THE PHYSICIAN AND PATIENT OF
WELL FAST-FORWARD WE'RE BACK BEFORE THIS COURT 15 YEARS LATER WITH A LEGISLATURE
WHO HAS CHOSEN TO NULLIFY THE CONTRACTUAL ACTION BETWEEN THE PHYSICIAN AND
THE PATIENT AND IN THE WORKERS COMP ARENA WE'RE ASKING THIS COURT FOR A BRIGHT-LINE
RULE THERE IS A STATUTE OF LIMITATIONS. IT'S TWO YEARS. IN EVERY STATUTE
OF LIMITATIONS IN THIS STATE THERE ARE ALWAYS EXCEPTIONS TO THE RULE. THERE'S
ALWAYS CASES WHERE THERE IS GOING TO BE RELIANCE, ESTOPPEL WAIVER GOOD FAITH
ARGUMENTS THAT WILL HAVE TO BE BROUGHT BEFORE THE DIVISION AND IF THE DIVISION
DETERMINES THAT IT'S NOT WORK RELATED, NOTHING STISHS THE CLAIM ANY LONGER IT
IS STILL A CONTRACTUAL CLAIM IF IT'S NOT UNDER THE WORKERS' COMPENSATION ACT SO
WE'RE ASKING COURT FOR YES WE NEED A BRIGHT-LINE RULE THAT IT IS TWO YEARS.
THE JURISDICTION OF THE DIVISION OF WORKERS' COMPENSATION IS LIMITED TO TWO YEARS.
THESE ARE WHETHER YOU CLASSIFY PHYSICIANS AS CLAIMANTS UNDER THE ACT IT
IS CERTAINLY A CLAIM FOR WORKERS' COMPENSATION BENEFITS. AND
IF THERE'S NO BENEFITS PAYABLE BECAUSE IT'S NOT COVERED BY THE ACT, YOU GO TO
SUPERIOR COURT, YOU HAVE THE DEFENSE THAT THE TIME SHOULD BE TOLD WHILE YOU WERE
LITIGATING THIS ISSUE BEFORE THE DIVISION OF WORKERS COMP BUT GOING BACK TO THE
STATUTE THE STATUTE TALKS ABOUT EXCLUSIVE JURISDICTION FOR DISPUTED MEDICAL
CHARGES. THERE ARE APPROXIMATELY 7,000 CASES PENDING BEFORE THE DIVISION OF
DISPUTED MEDICAL CHARGES. WHAT DOES THIS MEAN? IT MEANS THAT OUT OF NETWORK PHYSICIAN
FES OR YOU KNOW, PHYSICIAN WHO DO NOT HAVE AN ARRANGEMENT WITH AN EMPLOYER
AND THEREFORE HAVE NO FEE SCHEDULE BECAUSE NEW JERSEY DOES NOT HAVE A FEE
SCHEDULE OR A NEGOTIATE FEE AGREEMENT, ARE SUING BECAUSE WHATEVER THEY'RE PAID,
THEY CLAIM WAS NOT USUAL CUSTOMARY AND REASONABLE. THERE ARE REASONABLE
CHARGES. THAT'S THIS CASE. EVERY SINGLE CLAIM BEFORE THE COURT IS THIS CASE.
90 PERCENT OF THE CASES PENDING BEFORE THE DECISION ARE ABOUT U C-R, THE HOSPITAL
STAYED IN THEIR BRIEF THEY HAVE THOUSANDSS OF CASES PENDING BEFORE THE DIVISION
ABOUT U C-R. THERE IS NO REASON WHY A BRIGHT-LINE RULE CAN'T BE APPLIED FOR
TWO YEARS. YOU GET A STATEMENT, THERE'S NOT A QUESTION AS WHETHER IT'S A COVERED
CLAIM. THERE'S A QUESTION OF WHETHER YOU WERE ENTITLED TO $3,000 OR $8,000.
WHY APPLY A SIX-YEAR STATUTE OF LIMITATIONS? WE'VE GOT THE WORKERS' COMPENSATION
RATE SYSTEM IS RETROSPECT YOU LOOK BACK THREE YEARS. NOW EMPLOYEES ARE
NOW GETTING CLAIMS FILED FOR MEDICAL EXPENSED THEY PAID FIVE YEARS AGO, SIX YEARS
AGO THAT THEY HAVE NO KNOWLEDGE OF THAT THEY HAVE NO REASON TO ASSUME BEYOND
THE TWO YEARS THAT THERE'S ANY DISPUTE FOR PAYMENT. THE PHYSICIANS
FOLLOW THIS PROCEDURE THIS OTHER ARENAS, IT'S FOLLOWED IN THE AUT TO INSURANCE
ARENA THERE'S CLAIM PAYMENT AND CLAIM SUBMISSION DEADLINES UNDER HEALTH
INSURANCE LAWS. THERE'S NO REASON, THERE'S NO POLICY REASON WHY SIX YEARS NEEDS
TO APPLY. YES, THERE ARE CONTRACTUAL CLAIMS. AND NOT TO SAY THAT THESE
ARE ALL STATUTORY CLAIMS THERE MAY BE A PREFERRED PROVIDER AGREEMENT BETWEEN THE
INSURANCE COMPANY AND THE HOSPITAL, OR THE MEDICAL PROVIDERS AND THE INSURER.
IN THOSE CASES, IF THERE IS A BREACH OF THE PREFERRED PROVIDER ORGANIZATION AGREEMENT
OR OTHER AGREEMENT THOSE AGREEMENTS USUALLY HAVE THEIR OWN STATUTE OF
LIMITATIONS, THEIR OWN DISPUTE RESOLUTION PROCEDURES, AND IF THE CLAIM NOT ABOUT
A DISPUTED MEDICAL CHARGE, WHICH IS USUALLY A CODING DISPUTE, THEN IT GOES
TO THE SUPERIOR COURT AS A CONTRACTUAL ACTION. FOR EXAMPLE, IF THERE'S A BREACH
OF CONFIDENTIALITY PROVISION OR NONCOMPETE PROVISIONS THAT DOESN'T GO BEFORE
THE DIVISION OF WORKERS' COMPENSATION. BUT WE'RE TALKING HERE ABOUT A VERY LIMITED
CLASS OF CLAIMS. WE'RE NOT TALKING ABOUT THE CASE WHERE IT'S A GOT YOU
SITUATION WHERE AN EMPLOYEE GOES TO GET TREATMENT. WE'VE ALL FILLED OUT THE FORMS.
IS IT WORK RELATED? IF THEY CHECK OFF NO, AGAIN THE DOCTOR IS NOT SUPPOSED
TO KNOW THAT. BUT THEY GET THE HEALTH INSURANCE INFORMATION AND IT'S SUBMITTED
TO THE HEALTH INSURANCE CARRIER. THE SAME WAY IF IT'S THEY WILL CONTACT
THE EMPLOYER IF IT IS, IF THE BOX IS CHECKED THEY WILL CONTACT AN AUTO INSURANCE
CARRIER. IS THIS AUTO RELATED? WE'RE ASKING THIS COURT TO SET A BRIGHT-LINE
RULE. WE BELIEVE THAT THE HISTORY OF THE WORKERS' COMPENSATION ACT MAKES CLEAR
THAT THE JURISDICTION OF THE DIVISION IS LIMITED TO DO 2 YEARS. AND THERE'S
SOLID POLICY REASONS FOR THAT DETERMINATION. IT'S NOT THE FIRST TIME THE
COURTS BEEN CALLED UPON TO INTERPRET A STATUTE AND TO REACH A RESULT THAT IS
PERHAPS NOT CLEAR AND YES WE CONCEDE NO ONE ADDRESSED THE STATUTE OF LIMITATIONS
AND I WOULD SUBMIT IT WASN'T, YOU DIDN'T NEED TO ADDRESS IT. THE CONTRACT
CLAIM WAS EXTINGUISHED AND ALL CLAIMS FOR WORKERS' COMPENSATION BENEFITS UNDER
THE ACT HAVE ALWAYS BEEN LIMITED TO TWO YEARS. CHIEF JUSTICE
RABNER: THANK YOU. AMICUS: : THANK YOU. THE COURT:
MR. DICICCO. THE RESPONDENT: : MAY IT PLEASE THE COURT MIKE
SEEK ON BEFORE OF THE MEDICAL PROVIDERS IN THIS ACTION. I THINK THE DISPOSITION
OF THIS CONSOLIDATED APPEAL REALLY IS BASED MORE ON WHAT THE LEGISLATURE DID
NOT DO THAN WHAT IT DID. THE LEGISLATURE DID NOT AMEND THE 15-51 TO PROVIDE THAT
MEDICAL PROVIDERS ARE WITHIN A CLAIMANT FOR COMPENSATION AND IT DID NOT ADDRESS
THE STATUTE OF LIMITATIONS AT ALL IN 15-15. 15-15 IS A JURISDICTIONAL
STATUTE AS TO WHERE THE CLAIM MAY BE BROUGHT. IT DOESN'T DEAL AT ALL WITH THE
TIME PERIOD WITHIN WHICH THE CLAIM MAY BE BROUGHT. THE TIME PERIOD WITHIN
WHICH THE CLAIM MAY BE BROUGHT IS GARNERED BY THE NATURE OF OF THE CLAIM THAT IS
BROUGHT BY THE MEDICAL PROVIDER IN NOW EXCLUSIVELY THE WORKERS' COMPENSATION
DIVISION. IN CHRISTODOULOU, THIS COURT RECOGNIZED THAT THERE WAS
AN INDEPENDENT CLAIM BY THAT MEDICAL PROVIDER. AND IT INDICATED THAT THAT CLAIM
WAS STATUTORILY BASED, BASED ON THE WORKERS' COMPENSATION ACT. WHEN THERE
IS NOT AN EXPRESSED STATEMENT AS TO THE STATUTE OF LIMITATIONS THAT APPLIES TO A
STATUTORY CLAIM, THE LAW IS VERY CLEAR UNDER PRIOR SUPREME COURT PRECEDENT
AND I WILL CITE THE MONDAY TELL CASE WHICH IS AN LAD CASE IN WHICH THE COURT INDICATED
YOU NEED TAKE A TAKE A LOOK AT THE NATURE OF THE INJURY TO ASCERTAIN WHAT
TYPE OF CLAIM IS BEING PURSUED. AND IN THIS TYPE OF CASE, WHEN A MEDICAL PROVIDER
IS BRINGING A CLAIM IN THE DIVISION, IT'S AN ECONOMIC CLAIM. IT'S A CLAIM THAT
MAY NOT BE FOR BREACH OF CONTRACT BUT IT'S BASED ON A CONTRACT THAT IT MADE WITH
THE, WITH THE PATIENT. AND I WANT DEAL WITH SOMETHING THAT JUSTICE ALBIN
STATED ABOUT A THIRD PARTY BENEFICIARY STATUS. I FOUND THAT ARGUMENT INTRIGUING
AND I THOUGHT ABOUT THAT ARGUMENT. AND I TAKE A LOOK AT N.J.S.A. 34:15-9, AND
THE ORIGINAL WORKERS' COMPENSATION ACT AND IT READS THAT EVERY CONTRACT OF
HIRING MADE SUBSEQUENT TO THE FOURTH DAY OF JULY 1911, SHALL BE PRULED TO BE BEEN
MADE WITH RETURNS TO THE PROVISIONS OF THIS ARTICLE AND UNLESS THERE BE
A PART OF SUCH CONTRACT AN EXPRESSED STATEMENT IN WRITING PRIOR TO ANY ACCIDENT
EITHER IN THE CONTRACT ITSELF OR BY WRITTEN NOTICE FROM EITHER PARTY TO
THE OTHER THAT THE PROVISIONS OFS OF THIS ARTICLE ARE NOT INTENDED TO APPLY THEN
THE WORKERS' COMPENSATION ACT DOES APPLY. AND CREATES A CONTRACT BETWEEN
THE EMPLOYER AND THE WORKER AS TO WORKERS COMP WILL BE THE BENEFIT YOU HAVE, NOT
A TORT. AND I SUBMIT THAT THE MEDICAL PROVIDER IS A THIRD PARTY BENEFICIARY
OF THAT VERY CONTRACT THAT IS FORMED UNDER N.J.S.A. 34:15-9. THE
SPEAKER: I ALSO SUBMIT THAT EVERY ASPECT OF THE CLAIM BY THE MEDICAL PROVIDER IS
A CONTRACT CLAIM THE GRAVAMEN OF THE HARM IS HE'S NOT BEING PAID FOR A SERVICE
RENDERED. AND/OR NOT BEING PAID THE CORRECT AMOUNT FOR A SERVICE RENDERED.
AS A RESULT OF IN THE BEING PAID THE CORRECT AMOUNT FOR A SERVICE
RENDERED, HE HAS A CLAIM THAT HE CAN MAKE IN THE WORKERS COMP VISION IN FACT THAT
THAT HE HAS TO MAKE IN THE WORKERS' COMPENSATION DIVISION AND HE MAKES
THAT CLAIM BASED ON A SIX-YEAR STAM BECAUSE IT'S BASED ON KNOT A CONTRACT BECAUSE
HE'S NOT SUING ON THE CONTRACT OR NOT EXPANDING THE JURISDICTION OF THE
WORKERS' COMPENSATION DIVISION BY SAYING OKAY NOW YOU CAN CONSIDER CONTRACT CLAIMS
BUT WE'RE LOOKING AT THE ELEMENTS OF THAT CLAIM AND IT HAS TO BE PAID USUAL
AND CUSTOMARY AND REASONABLE. AND IF IT'S NOT BEING PAID UNDER THOSE CRITERIA,
THEN IT IS AN ECONOMIC INJURY THAT SHOULD BE GOVERNED BY A SIX-YEAR STAM NOT
SKPROMLY LA CONTRACT CRIMINAL RESTRAINT BUT A CLAIM THAT HAS ALL OF THE INCIDENTS
OF A CONTRACT CLAIM AND AND I THINK THE COURT HAS RECOGNIZED THAT THAT REQUIRES
A SIX-YEAR STATUTE OF LIMITATIONS. WITH RESPECT TO THE ACTUAL LANGUAGE
USED IN THE STATUTE, WE'VE ALL AGREED THAT THERE IS NO MENTION OF A STATUTE OF
LIMITATIONS. AND THE APPELLATE DIVISION HAD IT CORRECTLY, HAD THERE INTENDED
TO BE SUCH A SEED CHANGE IN THE LAW REGARDING THE PERIOD OF LIMITATIONS WITHIN
WHICH A CLAIM COULD BE MADE IN THE DIVISION, THEN IT WOULD HAVE SAID TO MUCH
MORE CLEARLY. WE'VE HEARD SIGNIFICANT PUBLIC POLICY ARGUMENTS ABOUT ALL OF THE
COURTS BEING WORKERS' COMPENSATION DIVISION IS BEING overburdened BY THE
NUMBER OF CLAIMS FILED WELL IF THE WORKERS' COMPENSATION DIVISION DOESN'T GET TO
WRITE THE LEGISLATION THAT CAN REVIEWS THEIR WORKLOAD THE LEGISLATURE DID
THAT AND IT DID IT HERE BY SAYING OKAY, EXCLUSIVE JURISDICTION ON THESE CLAIMS
AS PRESENT. BUTTRESSINGLY IT DIDN'T ELIMINATE THE CONTRACTUAL CAUSE OF
ACTION CONTRACTUAL CAUSE OF ACTION EXISTS AND CAN STILL BE FILED IF IN ACT THE
CLAIM IS NOT RELATED TO A WORK INJURY. CHIEF JUSTICE RABNER:
DEAL DIRECTLY WITH THE ARGUMENT THAT WE'VE HEARD LEGISLATURE HAS SAID IN 2012
IF THERE'S A DISPUTE OF COMPENSATION FOR A WORK RELATED JURY YOU MUST GO
TO WORKERS COMP IMPLICIT IN THAT IS YOU PLAY BY THE RULES OF WORKERS' COMPENSATION
WHICH CALLS FOR TWO YEARS STATUTE OF LIMITATIONS. THE
RESPONDENT: : THE RULES OF WORKERS COMP ARE SET BY THE LEGISLATURE AS FAR AS THE
STATUTE OF LIMITATIONS. THAT TWO-YEAR LIMITATION IS NOT SET FORTH AS
APPLICABLE TO A MEDICAL PROVIDER'S CLAIM. IT'S APPLICABLE TO A CLAIMANT FOR COMPENSATION
BIT THAT HAS NEVER BEEN INTERPRETED TO BE A MEDICAL PROVIDER. A CLAIMANT
FOR COMPENSATION UNDER 15-51 IS SEPARATE AND APART FROM A MEDICAL PROVIDER IF YOU
LOOK CLOSELY AT THE STATUTE YOU CAN SEE IT IS SET UP IN A WAY THAT REQUIRES
THE PETITION TO BE FILED UNDER 15-51 INCLUDE ALL KINDS OF INFORMATION THAT A MEDICAL
PROVIDER WOULD NEVER INCLUDE OR COULD INCLUDE IN ITS CLAIM. SHALL STATE
RESPECTIVE ADDRESS OF THE PETITIONER THE FACTS RELATED TO THE EMPLOYMENT AT THE TIME
OF THE INJURY. THE SPEAKER: THE INJURY AND IT'S EXTENT AND CHARACTER.
THE AMOUNT OF WAGES RECEIVED AT THE TIME. I SUBMIT THAT RESPONDENT SUBMIT THAT
15-51 HAS NO APPLICABILITY TO A MEDICAL PRETRIAL INTERVENTION IT'S TO A
CLAIMANT WHETHER IT'S BE ADDENDUM ADDENDUM DENT ACTUAL INJURED WORK AND THE STATUTORY
SCHEME SET FORTH IN 51 IS BASED ENTIRELY ON THAT DEFINITION OF A CLAIMANT
FOR COMPENSATION. THIS COURT HAS HELD THAT PAYMENT OF MEDICAL -- THAT THE PAYMENT
OF MEDICAL BENEFITS TO THE PROVIDER IS NOT COMPENSATION. IT'S SEPARATE.
JUSTICE ALBIN: EVERYTHING DEPENDS UPON HOW YOU READ 15-15
WHETHER OR NOT THAT CHANGED THE DEFINITION OF WHO A CLAIMANT IS. SO LET'S JUST
READ IT TOGETHER FOR A SECOND. EXCLUSIVE JURISDICTION FOR ANY DISPUTED
MEDICAL CHARGE ARISING FROM ANY CLAIM FOR COMPENSATION FOR A WORK RELATED INJURY.
LET'S STOP RIGHT THERE. SO WE HAVE SAY THERE'S A MEDICAL CHARGE. ARISING
FROM ANY CLAIM FOR COMPENSATION FOR A WORK RELATED INJURY. IF THE MEDICAL PROVIDER
FILES A CLAIM IN THE WORKERS' COMPENSATION COURT, IS THE MEDICAL CHARGE
NOW ARISING FROM A CLAIM FOR COMPENSATION FOR A WORK RELATED INJURY BROUGHT BY
THE DOCTOR? YOU FOLLOWING ME? THE RESPONDENT: :
THE RESPONDENT: : I DON'T KNOW IF I AM JUSTICE AND I APOLOGIZE FOR THAT.
JUSTICE ALBIN: I'M TRYING TO FIGURE OUT WHETHER OR NOT UNDER THAT LANGUAGE
THE MEDICAL PROVIDER BECOMES THE CLAIMANT. THE RESPONDENT: :
I DON'T THINK IT DOES JUDGE. JUST I BELIEVE WHEN IT SAYS ANY CLAIM FOR
COMPENSATION THAT'S REFERRING TO THE UNDERLYING WORKERS CLAIM.
JUSTICE ALBIN: LET'S SAY HE HASN'T THERE IS NO WORKERS COMP CLAIM. IF THE WORKER
HAS GONE TO HIS PHYSICIAN, HE'S CHECKED OFF THAT LITTLE BOX THAT THIS IS
A WORK RELATED INJURY. PAYMENT HASN'T BEEN MADE BY THE CARRIER. THE PHYSICIAN
NOW GOES INTO COURT WITH HIS DISPUTED MEDICAL CHARGE AND NOW SETS THE WHEELS IN
MOTION IN WORKERS' COMPENSATION COURT. WHAT I'M TRYING TO FIGURE OUT IS
WHETHER OR NOT THE MEDICAL PROVIDERS I'LL CALL IT CLAIM PETITION WHETHER THAT IS
ARISING FROM A CLAIM FROM COMPENSATION FO WORK RELATED INJURIES UNDER THOSE
CIRCUMSTANCES DO YOU UNDERSTAND WHAT I'M SAYING. THE RESPONDENT: :
I DO JUSTICE AND YES IF IT IS A CLAIM FOR COMPENSATION THEN THERE IS EXCLUSIVE
JURISDICTION AND THAT'S A DECISION. JUSTICE ALBIN: MY QUESTION
THEN IS IS THE MEDICAL PROVIDER A CLAIMANT UNDER THIS LANGUAGE? I UNDER THE
LANGUAGE IN 15-15 YES I SUBMIT THAT HE IS A CLAIMANT FOR COMPENSATION BECAUSE THAT
TRIGGERS HIS EXCLUSIVE, THE EXCLUSIVE JURISDICTION ELEMENT OF THE PROVISION.
JUSTICE ALBIN: DOES THE MEDICAL PROVIDER THEN BECOME A CLAIMANT
UNDER 15-51? THE RESPONDENT: : I DON'T THINK HE DOES JUDGE
WITHOUT A LEGISLATIVE DETERMINATION ON THAT POINT. BECAUSE NOW WE'RE TWISTING
AND TURNING AND TRYING TO FIT A CERTAIN. JUSTICE ALBIN: THE REASON
I'M ASKING THE CLAIMANT FOR PURPOSES THAT OF 15, 15 BUT NOT FOR PURPOSES
OF 15-51 HOW DO WE WORK THAT OUT? THE RESPONDENT: : I THINK WE HARKEN
BACK TO THE TO THE NATURE OF THE CLAIM BEING MADE BY THE MEDICAL PROVIDER.
JUSTICE ALBIN: 1551 DOESN'T MAKE ANY DISTINCTIONS JUST TALKS ABOUT
A CLAIMANT. THE RESPONDENT: : IT DOES BUT IT DOESN'T MENTION
A CLAIMANT IN THE CONTEXT OF A MEDICAL PROVIDER. THE CLAIMANT DEFINITION THERE
SEEMS PRETTY OBVIOUS THAT IT MEANS A SIMPLE A WORK WHO HAS BEEN INJURED.
JUSTICE SOLOMON: CAN YOU ASK YOU ONE QUESTION JUST TO CLARIFY
SOMETHING YOU SAID BEFORE. THE MEDICAL PROVIDER PROVIDES TREATMENT. THE MEDICAL
PROVIDER GETS PARTIAL PAYMENT FROM THE WORKERS' COMPENSATION CARRIER BUT
THERE'S A DISPUTE AS TO WHAT IS FAIR AND REASONABLE COMPENSATION. SO THE CLAIM
BY THE PROVIDER IS THERE'S A BALANCE DUE I DIDN'T GET WHAT I WAS ENTITLED
TO YOU OWE ME $1,000. IS IT YOUR CONTENTION THAT THAT IS A CLAIM THAT THE
PROVIDER CAN NOW BRING UNDER THE STATUTE OF LIMITATIONS SIX-YEAR STATUTE OF
LIMITATIONS? THE RESPONDENT: : YES. IN THE WORKERS' COMPENSATION
DIVISION. JUSTICE SOLOMON: BUT THERE'S NOT NECESSARILY A DISPUTE
ABOUT IT BEING WORK RELATED. THE ONLY DISPUTE IS THE AMOUNT OF THE BILL HOW MUCH
CAN BE, SHOULD BE PAID. CORRECT? THE RESPONDENT: : CORRECT
BUT IT EMANATES PROSECUTE A WORK RELATED INJURY AND THOUSANDS SO.
JUSTICE SOLOMON: IS THAT WHAT MOST OF WHAT PEER DEALING WITH. THE
RESPONDENT: : I THINK THAT IS WHAT WE'RE DEALING WITH IN THESE FIVE CASES BY THESE
PETITION ENTERS. JUSTICE SOLOMON: BY THESE FIVE CASES IN WORK
THEY WERE AWARDED BENEFITS INCLUDING MEDICAL EXPENSES THAT WERE PAID TO THE
PROVIDERS AT A CERTAIN RATE WHATEVER THAT RATE IS, AND WITHIN NOT WITHIN TWO YEARS
OF THAT BILL, THEY BROUGHT A CLAIM SAYING THEY WERE OWED MORE MONEY FOR
THAT SAME TREATMENT. THE RESPONDENT: : THAT'S CORRECT.
JUSTICE SOLOMON: OKAY I'M JUST MAKING SURE. THE RESPONDENT: : YES,
THAT'S THE NATURE, THAT'S THE GENESIS OF THESE CLAIMS. JUSTICE
SOLOMON: JUST MAKING SURE. [!SPEAKER2] THEY CAME THROUGH THE DIVISION.
JUSTICE SOLOMON: I GOT YOU. JUSTICE LA VECCHIA: DO YOU HAVE
ANY SUPPORT YOU SAID BEFORE THE LEGISLATIVE HISTORY IS SILENT. DOES
THE TAX FORCE REPORT THAT WAS DRIVING THIS ISSUE INITIALLY BY THE DIVISION OF WORKERS'
COMPENSATION BACK IN 2010 SHED ANY LIGHT ONE WAY OR THE OTHER ON THE ARGUMENTS
WE'RE HEARING ON THE STATUTE OF LIMITATIONS. THE RESPONDENT: : IT DIDN'T
ADDRESS THE STATUTE OF LIMITATIONS AT ALL. I KNOW THAT JUDGE MARTINO OF,
INTERPRETED TO, TO BE SUCH THAT THE PROCEDURES WOULD REMAIN IN PLACE WHICH WOULD
MEAN THE STATUTE OF LIMITATIONS WASN'T. JUSTICE LA VECCHIA: BUT
THERE'S WHO MENTION. THE RESPONDENT: : BUT THERE IS NO MENTION AT
ALL. AND I THINK THAT IS STRING EVIDENCE OF WHAT THE STATUTE MEANS THERE WAS
NO INTENT THERE WAS NO RECOGNITION THERE WAS NO STUDYING OF THAT STATUTE OF
LIMITATIONS AND WHAT IN FACT THE AMENDMENT, WHAT HE EFFECT IT HAD ON THE STATUTE OF
LIMITATIONS AND I SUBMIT THAT THE ABSENCE OF THAT LANGUAGE OR INFORMATION
CONTAINED IN THAT LEGISLATIVE HISTORY INDICATES THAT THERE WAS NO INTENT TO CHANGE
THE STATUTE OF LIMITATIONS WHICH HAD BEEN A SIX-YEAR AND HAS ALWAYS BEEN
SIX-YEAR. JUSTICE LA VECCHIA: BUT IN THAT TASK FORCE REPORT IT
DOES PRESUME THAT THERE'S ALREADY A CLAIM THAT'S BEEN PROCESSED THROUGH THE DIVISION
OR IS CURRENTLY PENDING THERE'S A DEBATE OVER NO LONGER REQUIRING MOTIONS
TO INTERVENE BUT JUST ALLOW THE MEDICAL PROVIDER CLAIM TO BE MESH WITH THE UNDERLYING
CLAIM OF THE INJURED WORKER SO WE'RE ALREADY WITHIN THE CONTEXT OF CLAIMS
THAT ARE CONTROLLED BY THESE VARIOUS TWO-YEAR PERIODS ARE WE NOT?
THE RESPONDENT: : THERE ARE VARIOUS CLAIMS YES THERE ARE VARIOUS CLAIMS CONTROLLED
BY THE TWO-YEAR PERIOD. THIS HAS NEVER BEEN ONE THIS MEDICAL PROVIDER CLAIM
AND I DON'T THINK THE LEGISLATIVE HISTORY INDICATES IT WAS MEANT TO BE EXPANDED
TO INCLUDE THIS NOW IN THOSE CLAIMS THAT HAD ALWAYS BEEN SUBJECT TO THE
TWO-YEAR STATUTE OF LIMITATIONS IN 15-51. JUSTICE ALBIN: I WANT TO UNDERSTAND
THE FULL BREATH OF YOUR ARGUMENT. THE RESPONDENT: : SORRY.
JUSTICE ALBIN: I WANT TO UNDERSTAND THE FULL BREATH OF YOUR
ARGUMENT. SO WORKER GOES TO PHYSICIAN ON JANUARY 1ST TO HAVE SOME MEDICAL PROCEDURE
THAT THE PATIENT SAYS IS WORK RELATED. THE WORKERS COMP CARRIER IN FEBRUARY,
PAYS WHAT IT THINKS THE PHYSICIAN IS OWED, THE PHYSICIAN THINKS HE'S OWED A LOT
MORE. THEN FIVE YEARS AND TEN MONTHS LATER THE PHYSICIAN BRINGS A CASE IN
THE WORKERS COMP COURT. THERE'S NO PENDING ACTION THERE. YOUR POSITION IS THAT
THEY CAN DO THAT. THE RESPONDENT: : YES IT IS YOUR HONOR BASED
ON THE NATURE OF THAT CLAIM BEING AN ECONOMIC CLAIM WHICH WOULD REQUIRE A SIX-YEAR
STATUTE OF LIMITATIONS. CHIEF JUSTICE RABNER: IS THERE ANYTHING ELSE
YOU WOULD LIKE TO ADD. THE RESPONDENT: : NO IF THERE ARE ANY
OTHER QUESTIONS. CHIEF JUSTICE RABNER: OTHER QUESTIONS THANK
YOU MR. THE RESPONDENT: MAY IT PLEASE COURT I JUST WANT
TO ADDRESS THE QUESTION OF CLAIMANT IN THE WORKERS' COMPENSATION ACT. WE DID A
THOROUGH ANALYSIS IN OUR BRIEF OVER EVERY TIME THEY UTILIZED THAT TERM CLAIMANT
IN THE ACT AND I THINK IT'S PRETTY CLEAR IF YOU LOOK THROUGH EVERY SINGLE PROVISION
OF THAT ACT WHERE THAT WORD IS USED IT REALLY IS AN EQUIVALENT WITH TERM
EMPLOYEE. SO IF YOU TAKE A LOOK AT SECTION 15 THEY DON'T USE THE TERM CLAIMANT
THEY TALK ABOUT FILING A CLAIM BIT THE TERM CLAIMANT IS NOT THERE. THEREFORE,
THE WHEN THE LEGISLATURE WROTE THE ACT I THINK THEY MEANT CLAIMANT TO BE
INSTANT MOUSTACHES WITH EMPLOYEE. JUSTICE ALBIN: ORIGINALLY BUT THE
QUESTION IS DOES FIN CHANGE THAT AND YOUR COLLEAGUE SAID WELL UNDER THAT
LANGUAGE, I GUESS THERE ARE A CLAIMANT. THE RESPONDENT: I BELIEVE HE'S
MISTAKEN JUDGE AND ONCE AGAIN THEY TONE USE THE TERM CLAIMANT THERE. AND
I THINK CLAIMANT IS MEANT AS TERM OF A RIGHT TO MEAN SOMETHING VERY SPECIFIC IN THE
ACT AND THEY DIDN'T USE IT IN 15, MAYBE FOR A REASON. JUSTICE ALBIN:
WHAT DOES ARISING FROM ANY CLAIM MEAN IF 15-15 IF THE WORKER HASN'T BROUGHT THE
CLAIM? WHAT DOES IT MEAN. THE RESPONDENT: WELL I'M LOOKING AT
15 IN THE LANGUAGE THERE A LITTLE DIFFERENTLY THAN OTHERS BUT THE NEW
LANGUAGE THAT THEY ADD THEY TALK ABOUT FEES FOR TREATMENT OR MEDICAL SERVICES THAT
HAD BEEN AUTHORIZED BY THE EMPLOYER OR DETERMINED BY THE DIVISION TO BE THE
RESPONSIBILITY OF THE EMPLOYER. SO THOSE ARE TWO THINGS WHERE THEY EITHER AUTHORIZED
IT OR THERE'S ALREADY BEEN A DETERMINATION BY THE DIVISION THAT THIS IS
AUTHORIZED TREATMENT. OKAY OR COMMENCEABLE TREATMENT THEN IT GOES EXCLUSIVE
JURISDICTION FOR ANY DISPUTED MEDICAL CHARGE IT DOESN'T SAY SERVICE THAT'S
AN INTERESTING CHOICE OF WORDS CHARGE. AND I THINK THAT'S SUPPOSED TO MEAN IF WE'RE
FIGHTING OVER HOW MUCH, THEN IT HAS TO GO THERE. IF THEY USE THE WORD SERVICE,
I MIGHT HAVE A DIFFERENT VIEW OF THAT BUT I THINK THAT WORD CHARGE THERE MEANS
SOMETHING SIGNIFICANT. JUSTICE LA VECCHIA: THAT DEFINITION WOULD
THEN TIE INTO THE LEGISLATIVE USE OF BALANCE BILLING WE ARE REFERRING BACK
TO SOMETHING THAT'S ALREADY BEEN DETERMINED TO BE COVERED BY WORKERS'
COMPENSATION SCHEME RIGHT. THE RESPONDENT: ABSOLUTELY JUSTICE.
YES, ONE THING I HEARD THAT SOMEONE WAS TRYING TO BILLING THE PATIENT IN
THE WORKERS' COMPENSATION CASE WITH BALANCE BILLING THAT'S IN THE ALWAYS THE CASE
THAT THE CHARGES ARE COMPLETELY DENIED THAT'S NOT BALANCED PILLING IT'S
WHETHER YOU RECEIVE A PAYMENT FOR THOSE SERVICES AND YOU DON'T THINK IT'S INTERVIEW
OF THEN GO AFTER THE PATIENT THAT IS ACTUALLY BALANCED BILLING SO THAT IS
YOU KNOW SO I THINK IT'S SOMETHING WE HAVE TO LOOK AT 15 VERY PARTICULARLY TO SEE
WHAT THEY MEANT THERE. JUSTICE LA VECCHIA: ISN'T THAT THE EXPRESSED
LEGISLATIVE TEN TOY HIM IN THIS STATEMENT BALANCED BILLING. THE
RESPONDENT: YES ABSOLUTELY BUT IF THE CHARGES ARE DENIED OUT RIGHT THEN IT WOULDN'T
CONSTITUTE BALANCED BILLING IF THEY SAY THESE ARE NOT WORK RELATE YOU KNOW
WE DID NOT. JUSTICE LA VECCHIA: IS THERE ANY SCENARIO WHERE THE
LAW DIVISION CAN DECIDE ABOUT SOMETHING IS COMPENSABLE OR NOT IS THAT A DETERMINATION
THAT HAS TO BE MADE ONLY BY THE DIVISION OF WORKERS' COMPENSATION?
THE RESPONDENT: THAT'S A GOOD QUESTION. JUSTICE LA VECCHIA: ASSUME
THAT THE ANSWER WAS THAT IT HAD TO BE MADE BY THE DIVISION OF WORKERS'
COMPENSATION. THE RESPONDENT: I COULD FORESEE MAYBE SOME LITIGATION
WHERE IT WOULD COME UP BUT IN THE MAJORITY OF THE CASES PROBABLY IT'S GOING TO BE
IN THE DIVISION I WOULD AGREE. JUSTICE LA VECCHIA: AND DOESN'T
THE EXCLUSIVE LANGUAGE, EXCLUSIVE JIK HELP SUPPORT THAT? THE
RESPONDENT: ABSOLUTELY. JUSTICE LA VECCHIA: OKAY. THE
RESPONDENT: BUT YOU KNOW OUR, WE DID NOT ARGUE FOR SIX YEARS. WE TOOK A SORT OF
NUANCE VIEW AND REALLY LIKE TO REMIND THE COURT ABOUT THAT NOW. BECAUSE
WE ALSO HAD A BIG PROBLEM WITH JUDGE MARTINO'S DECISION BECAUSE WE DON'T THINK
HE FOLLOWED THE ACT AND THERE'S A WAY TO FOLLOW THE ACT AND GET HAVE TWO YEARS
APPLY BUT TO DO TONIGHT DIFFERENT WAY THAN JUDGE MARTINO DID HE WANTED TO
BREAK DOWN EVERY DATE OF SEVER SEPARATELY AND SO THIS DATE OF SOEFRS IS ONE STATUTE OF
LIMITATIONS THE NEXT DATE IS ANOTHER STATUTE OF LIMITATIONS AND THE PAYMENT
ON THIS ONE DOESN'T AFFECT THE STATUTE ON THAT ONE AND THAT DOESN'T MAKE ANY SENSE
TO ME BECAUSE THE WORKERS' COMPENSATION ACT DOESN'T MAKE THOSE KIND OF
DISTINCTION DOLLARS SECTION 51 DIDN'T TALK ABOUT THAT IT JUST TALKS ABOUT PAYMENT
AND THE PAYMENT WILL RESTART THE STATUTE. SO OUR VIEW IS TO LOOK AT WOKKER,
MEDICAL PROVIDER CLAIMS IN THE DIVISION IN THE WAY THAT THE ACT TALKS ABOUT THEM.
WE ARE FILING CLAIMS IN THE DIVISION ON BEHALF OF THE INJURED WORKER SECTION
15 LITERALLY SAYS THAT. THE PHYSICIAN CAN FILE IT OR ANY OTHER PERSON CAN FILE
IT ON THE WORKERS BEHALF. SO WHAT DOES THAT MEAN SO IF OUR CLAIMS ARE
DERIVATIVE OF THE WORKERS WRITES WE'RE FILING THE CLAIMS ON THEIR BEHALF WHY DON'T
WE HAVE A SHARED STATUTE OF LIMITATIONS WITH THE WORKER SO THAT ANY PAYMENT
MADE TO THE WORKER OR ANOTHER PHYSICIAN WHO'S TREATING THE WORKER WOULD ALSO BE
APPLIED TO THE PHYSICIANS SO THAT EVERYONE HAS A SHARED STATUTE?
JUSTICE SOLOMON: YOU ARE SAYING JUST LIKE THE CLA IF THE MEDICAL PROVIDER HAS A
DISPUTE ABOUT A BILL IT'S TWO YEARS THE TWO YEARS STARTS TO RUN FROM THE
DATE OF THE LAST PAYMENT OF WORKERS' COMPENSATION BENEFITS WHETHER IT BE A DIFFERENT
MEDICAL BILL, A PARTIAL PAYMENT WHATEVER IT IS TWO YEARS FROM THAT DATE STARTS
THE TWO-YEAR STATUTE OF LIMITATIONS AND IT'S NOT COMPS DONE MAYBE A SECTION 50 OUT OF IT
WHATEVER, TWO YEARS LATER, YOU ARE OUT OF LUCK. THE RESPONDENT: YES
BUT THAT COULD GO ON FOR A WHILE SO. JUSTICE SOLOMON: SOME OF
THESE CLAIMS GO ON FOR YEARS AND YEARS AND YEARS. PARTIAL PAYMENTS CAN GO ON
FOR QUITE A LENGTH OF TIME. THE RESPONDENT: THAT IS TRUE. BUT I THINK
THAT'S COMPORTS WITH THE LANGUAGE UTILIZED IN THE ACT. YOU HAVE A WE HAVE
MEDICAL PROVIDERS FILING CLAIMS ON THEIR BEHALF AND THEN YOU HAVE, THE ACT TALKING
ABOUT YOU KNOW, CLAIMS I MEAN SECTION 51 REALLY IS TALKING ABOUT CLAIMS
BY INJURED WORKERS. AND IF LUKE AT THE CASES I CITED IN MY BRIEF THERE ARE CASE
INVOLVE DEPENDENCY CLAIMS AND PIP CLAIMS WHERE IT'S BEEN HELD THAT THE
DEPENDENT GETS THE BENEFIT OF ANY PAYMENT THAT THE ORIGINAL INJURED WORKER GOT AND
THAT THEY WOULD HAVE A SHARED STATUTE. SO OUT OF POSITION IS WHY NOT TREAT
JUST THROUGH MEDICAL PROVIDERS INTO THAT MIX SO THAT EVERYONE HAS A SHARED STATUTE
IT COMPORTS WITH CASE LAW AND IT COMPORTS WITH THE LANGUAGE OF THE ACT SO
NO ONE HAS BENDS OVER BACKWARDS TO TRY TO FIGURE OUT WHAT THIS STATUTE MEANS.
CHIEF JUSTICE RABNER: THANK YOU. MARTINEZ JUDGE MARTINEZ JUDGE MARZ GET
JARZ APPELLANT2: ON BEHALF OF THE MEDICAL SOCIETY OF NEW JERSEY, I JOIN
MY COLLEAGUE. MEDICAL PROVIDERS ARE NOT CLAIMANTS AND THEY NEVER HAD. WE'VE BEEN
DOING THIS FOR TWO YEARS NOW AND THE EMPLOYEE HAS A CLAIM PETITION. THEN THEY WERE
SPECIFICALLY INSTRUCTED YOU ARE NOT CLAIMANTS, YOU ARE MEDICAL PROVIDERS. AND A NEW APPLICATION
WAS CREATED SOLELY FOR THE MEDICAL PROVIDER TO FILE THEIR CLAIMS. REFERRED TO AS A MEDICAL
PROVIDER's APPLICATION FOR MEDICAL REIMBURSEMENT FOR MEDICAL TREATMENT, A SUPER RE-DID
YOU UNDERSTAND DANIEL NAMED DOCUMENT BUT IT EXISTS. THEY'VE NEVER BEEN TREATED AS
CLAIMANTS AND THEY'VE NEVER BEEN TREATED AS ANYTHING OTHER THAN MEDICAL PROVIDERS WHO ARE
LOOKING FOR REIMBURSEMENT FOR SERVICES THAT ARE PROVIDED. WHAT IS SO INTERESTING
IS THAT THERE'S THIS WHOLE DISCUSSION ABOUT HOW WE'RE CREATING NEW LAW, AND IT'S NEVER
BEEN SIX YEARS AND IT'S ALWAYS BEEN TWO YEARS AND, YOU KNOW, THE RESPONDENTS ARE SAYING
THAT, NO, IT'S ALWAYS BEEN SIX YEARS. WELL, GUESS WHAT, THERE'S A CASE, REMARKABLY, IN
1948 AULD OLDFIELD BY THIS COURT, THE SUPREME COURT. WHAT THE SUPREME COURT WAS ADDRESSING
IN OLDFIELD WAS A CLAIMANT SAYING THAT IT IS THE MEDICAL PROVIDER's RECEIPT OF PAYMENT
THAT TOLLS THE STATUTE OF LIMITATIONS. AND THE SUPREME COURT SAYS, THE EMPLOYER HAS A
STATUTORY DUTY. THAT STATUTORY DUTY IS TO PROVIDE MEDICAL TREATMENT. ONCE THEY'VE
PROVIDED THE TREATMENT, THE OBLIGATION BETWEEN THE EMPLOYER AND THE EMPLOYEE IS AT AN END.
THE CASE LAW SPECIFICALLY SAYS THEN, HOW OR WHEN HE SHALL PAY FOR THE SAME IS OF NO CONCERN
TO THE WORKMAN. THE VERY NEXT SENTENCE, THE SUPREME COURT THEN SAYS THAT THE EMPLOYER
CAN BE SUED BY THE PHYSICIAN AND THE STATUTE OF LIMITATIONS SIX YEARS. THAT'S WHAT IT
SAYS IN OLDFIELD. BOY, WAS I SURPRISED. I READ IT THE FIRST TIME FOR ONE THING. I WENT
BACK INTO IT IN ANTICIPATION FOR TODAY AND THEN THERE IT IS, STATUTE OF LIMITATIONS, SIX
YEARS, THE PHYSICIAN CAN SUE THE EMPLOYER IN A WORK-RELATED INJURY. JUSTICE
FERNANDEZ-VINA: WHERE DID THEY SUE? APPELLANT2: THEY SUED IN THE SUPERIOR
COURT AND IT WENT UP TO THE SUPREME COURT. JUSTICE SOLOMON: THEY CAN'T
SUE IN SUPERIOR COURT ANY MORE. APPELLANT2: THEY CAN'T. BUT IF YOU LOOK
AT THE AMENDMENT TO WHAT ACTUALLY HAPPENED IN 2012, WHAT THE LEGISLATURE SAID WAS THAT
THE EXCLUSIVE JURISDICTION OF THESE TYPES OF CLAIMS SHALL BE VESTED IN THE DIVISION OF
WORKER'S COMPENSATION. IT DOESN'T SAY THAT YOU HAVE TO FIND A WAY TO MAKE IT WORK FOR
MEDICAL PROVIDERS. THE SAME WAY IT DOES FOR CLAIMANTS. JUSTICE SOLOMON:
DO YOU AGREE THAT IF IT'S A DISPUTED CLAIM, PARTIAL PAYMENT IS MADE, THERE'S A DISPUTE
AS TO A BALANCE DUE FROM THE WORKER'S COMP CARRIER, THAT WORKER'S COMP CLAIM CAN BE
BROUGHT IN WORKER'S COMP WITHIN SIX YEARS? APPELLANT2: YES. AND SOMETHING
INTERESTING HAPPENS AS WELL. WHEN WE GET TO THAT TWO YEARS STATUTE OF LIMITATIONS, THAT
FUNNINESS BETWEEN A BREACH OF CONTRACT CASE IN SUPERIOR COURT FOR SIX YEARS AND THIS
ATTEMPT TO APPLY THE TWO-YEAR STATUTE OF LIMITATIONS TO A MEDICAL PROVIDER IN THE
DIVISION OF WORKER'S COMPENSATION. I BELIEVE IT WAS JUSTICE ALBIN THAT BROUGHT THIS UP.
HE SAID, WHAT IF THE MEDICAL PROVIDER ACT NOT GUILTY GOOD FAITH SAYS THIS IS NOT A
WORK-RELATED INJURY. I DON'T BELIEVE IT IS. I DON'T THINK IT IS. I'M GOING TO GO AHEAD
AND SUE. IT'S THREE YEARS NOW. I FILE MY CLAIM AGAINST MY PATIENT. LET'S SAY THE PATIENT
WAS PAYING. WHATEVER HAPPENED. HE WAS PAYING THE DOCTOR AND THEN FAENL HE TERMINATED.
THE DOCTOR SAYS I'M OWED $40,000. I'M GOING TO FILE A CLAIM AGAINST MY PATIENT. THREE
YEARS DOWN THE LINE. THE PATIENT THEN RETAINS COUNSEL, HAS TO DEFEND HIMSELF AND IN THAT
LAWSUIT SAYS, NO, THIS IS A WORK-RELATED INJURY. YOU HAD TWO YEARS TO FILE YOUR CLAIM
WITH THE DIVISION OF WORKER'S COMPENSATION. AND HE DIDN'T. NOW YOU ACTUALLY DO HAVE
-- JUSTICE SOLOMON: IS HOW IS THAT CLAIM MADE IN THE SUPERIOR COURT.
APPELLANT2: THE MEDICAL PROVIDER -- MY APOLOGIES. THE. JUSTICE
SOLOMON: A MOTION TO RE-MOVE IT TO WORKER'S COMP. APPELLANT2: RE-MOVE IT,
TRANSFER IT, WHATEVER YOU WANT -- JUSTICE SOLOMON: THE WORKER'S COMP JUDGE
WILL MAKE A DECISION. IF IT'S WORK RELATED, THEN WE HAVE A STATUTE OF LIMITATIONS ISSUE.
SPEAKER: BUT THEN THEY SAY THE JURISDICTION DOESN'T HAVE JURISDICTION OVER
THIS BECAUSE THE STATUTE OF LIMITATIONS HAS COME AND GONE ON THIS ISSUE. WE'RE NOW AT
THE THREE-YEAR MARK. SO IN ORDER FOR THE PLAINTIFF THE NOW DEFEND THEIR CASE, YOU MAY
HAVE A FILE WITH A JURY ON THE ISSUE OF WHETHER OR NOT THIS IS A WORK-RELATED INJURY AND
WHETHER OR NOT -- JUSTICE SOLOMON: CORRECT ME IF I'M WRONG. IF YOU GO INTO
COMP COURT AND THEY SAY IT IS WORK RELATED IT'S MORE THAN TWO YEARS AND YOU'RE DISMISSED,
YOU'RE DISMISSED. YOU'RE DONE. YOU CAN GO TO THE APPELLATE DIVISION. YOU CAN THEN COME
TO US. BUT YOU'RE DONE. YOU DON'T GO BACK TO SUPERIOR COURT. APPELLANT2:
BUT THERE'S NEVER A FILING BY THE PATIENT IN THE DIVISION OF WORKER'S COMPENSATION.
AND THAT'S JUST ONE, THAT'S JUST ONE WAY IN WHICH THIS WEIRD A MALOUF MEDICATION, THIS
WEIRD APPLICATION OF TWO YEARS VERSUS SIX YEARS, IN A BREACH OF CONTRACT IT'S A SIX-YEAR
STATUTE OF LIMITATION. JUSTICE SOLOMON: DOESN'T THIS HAPPEN ALL THE TIME?
APPELLANT2: DOES IT? JUSTICE SOLOMON: THERE'S A DISPUTE WHETHER
IT'S A WORK-RELATED INJURY, DISPUTE BETWEEN THE INSURANCE COMPANIES. THE WORKER'S COMP
HAS TO DECIDE IT AND IF THEY DECIDE, IT GOES, IT LEAVES. IT'S DONE. IT'S DISMISSED.
APPELLANT2: TODAY YOU HAVE MANY JUDGES AT THE DIVISION LEVEL THAT ARE SAYING
IT'S A SIX-YEAR STATUTE OF LIMITATIONS. YOU HAVE SOME SAYING IT'S A TWO-YEAR STATUTE OF
LIMITATIONS. SO CASES DO GET MISSED. SOME DON'T. SO YOU ACTUALLY HAVE THESE ISSUES
GO ON AND ON AND ON. THE CHALLENGE, THE CHALLENGE -- AND THAT MAY BE THE CASE THAT AS
WE GO ON AND WE DEAL WITH THESE ISSUES. BUT WHAT IS CLEAR -- CHRISTODOULOU SPOKE TO THIS.
IF THERE WAS AN INDEPENDENT CAUSE OF ACTION THAT THE MEDICAL PROVIDER HAD. WHETHER IT
AROSE UNDER RABINOWITZ, PURELY UNJUST ENRICHMENT. IN 2012, THE LEGISLATURE FOR WHATEVER
REASON AND I THINK CHRISTODOULOU SPOKE ABOUT THIS, THAT IT'S NOT ABOUT JURISDICTION, IT'S
ABOUT JUDICIAL EFFICIENCIES AND THE DIVISION HAVING THE SKILL SET TO DEAL WITH THESE KIND
OF ISSUES, PICKED UP IN 2012 THIS CAUSE OF ACTION AND DROPPED ILT INTO THE DIVISION OF WORKER'S
COMPENSATION. WHETHER THE MEDICAL PROVIDERS WANTED IT, WHETHER THE INSURANCE COMPANIES
WANTED IT IS OF NO MATTER. WE'RE HERE NOW. BUT WHAT THE LEGISLATURE DIDN'T DO IS CHANGE
THE STATUTE OF LIMITATIONS, CHANGE THE STATUS OF THE MEDICAL PROVIDER FROM ANYTHING OTHER
THAN A MEDICAL PROVIDER AND NOT A CLAIMANT. AND WHAT'S INTERESTING -- JUSTICE
ALBIN: UNLESS THEY DID IT I AM MRILT, WHICH IS WHAT YOUR ADVERSARIES ARE SAYING. OLDFIELD
IS RIGHT. SIX YEARS. BUT THEY'RE CLAIMING ONCE 15-15 WAS AMENDED TO GIVE WORKER'S COMP
EXCLUSIVE JURISDICTION AND THEY'RE CLAIMING YOU GUYS BECAME CLAIMANTS, THEN TWO YEARS.
AND THAT'S THE ISSUE BEFORE US. APPELLANT2: AND I -- LOOKING I'M GOING
TO CITE WHERE CITATION IS REQUIRED. I BELIEVE THE APPELLATE COURT SAID IT BEST. THAT
IN ORDER TO ACCOMPLISH THAT, TO COME TO THAT CONCLUSION, NOT ONLY DO YOU HAVE TO UPEND
80 PLUS YEARS OF SXREK LAW ADDRESSING THESE ISSUES, YOU THEN HAVE TO TAKE A SQUARE PEG,
FILE IT DOWN, BECAUSE OF A BELIEF THAT IT'S I AM MRILT STATED, TO FIT A SQUARE PEG INTO
A ROUND HOLE AND TO WHAT END. RIGHT. TO WHAT END? TO MINIMIZE AN ARTERY DATE, RIGHT?
THE STATUTE OF LIMITATIONS IS AN ARBITRARY DATE THAT'S SET. MEDICAL PROVIDERS ARE REQUIRED
TO RETAIN THEIR DOCUMENTS FOR YEARS, SEVEN YEARS AT MINIMUM. SO FOR WHATEVER REASON SIX
YEARS, BUT NOW THE LEGISLATURE BELIEVES THAT FOR WHATEVER REASON THIS ARBITRARY DATE HERE
IN THE DIVISION OF WORKER'S COMPENSATION SHOULD BE TWO YEARS. SO YOU'VE GOT TO UPEND
80 YEARS OF SUPREME COURT LAW, READ INTO THIS AMENDMENT, CHANGES THAT WOULD REQUIRE YOU
TO TAKE A MEDICAL PROVIDER, TURN THEM INTO A CLAIMANT AND ALL OF THE IMPLICATIONS THAT
COME WITH THAT. AND I THINK THE APPELLATE DIVISION DOES A FANTASTIC JOB AND COUNSEL IN
THEIR PAPERS DO A FANTASTIC JOB OF ADDRESSING THIS ISSUE. OF ALL THE THINGS THAT HAVE
TO CHANGE IN ORDER TO MAKE THIS WORK. AND THERE'S VERY LITTLE DISCUSSION ABOUT WHAT THE
IMPACT IS AND HOW THIS IS GOING TO BE APPLIED RETROACTIVELY TO MEDICAL PROVIDERS BECAUSE
THERE'S A GREAT MANY JUDGES AT THE DIVISION LEVEL THAT SAY IT'S A SIX-YEAR STATUTE OF
LIMITATIONS. SO WHAT HAPPENS TO THOSE CASES? WHAT HAPPENS TO ALL THE PENDING CASES THAT
ARE OUT THERE? SO WE'RE GOING THE RE-QUITE I AM MRILT AN AMENDMENT WITH RETROACTIVE
APPLICATION SOLELY FOR WHAT PURPOSE AND TO ACHIEVE WHAT END WHEN IT IS CLEAR THAT ALL ALONG
MEDICAL PROVIDERS HAVE BEEN TREATED SEPARATELY, RIGHT, NOT -- JUSTICE SOLOMON:
HOW DIFFICULT -- I DON'T MEAN TO STOP YOU. I KNOW YOU'RE ON A ROLL. HOW DIFFICULT IS
IT TO DO AND HOW MUCH DOES IT UPEND TO DO WHAT YOUR COLLEAGUE SAID, SIMPLY SAID, JUST
LIKE A CLAIMANT, A DOCTOR HAS TWO YEARS FROM THE DATE OF THE LAST PAYMENT TO MAKE A CLAIM?
HOW DIFFICULT IS THAT? HOW MUCH DOES THAT UPEND, HOW MUCH DOES THAT CHANGE? EVERY COMP
LAWYER, JUDGE IN THE WORLD UNDERSTANDS THAT KPT. APPELLANT2: SO IT UP ENDS
A LOT. I THINK JUSTICE ALBIN POINTED THIS OUT. THERE'S THIS WEIRD BACK AND FORTH THAT
HAS TO HAPPEN IN ORDER TO MAKE THIS WORK. IF IT'S THIS TYPE OF CASE, THIS HAPPENS. IF
DR. X PROVIDES SERVICES AND IS NOT REIMBURSED -- JUSTICE SOLOMON: EVERY
PRIVATE INSURANCE CLAIM. THAT HAPPENS IN EVERY AUTO ACCIDENT. THAT HAPPENS IN EVERY
CLAIM FOR MEDICAL TREATMENT EVER THAT'S EVER RESULTED IN ANY KIND OF LITIGATION IN ANY
COURT WITH JURISDICTION. IT HAPPENS EVERY DAY. APPELLANT2: I THINK OLDFIELD
DIRECTLY ADDRESSES THIS BECAUSE IT TALKS ABOUT WHAT'S IN YOUR KNOWLEDGE. SO YOU MAY HAVE
A MEDICAL PROVIDER THEN THAT SITS AND WAITS FOUR YEARS DOWN THE LINE, FILES A CLAIM,
WHICH WOULD OTHERWISE BE DISMISSED UNDER THE TWO-YEAR STATUTE OF LIMITATION, BUT BECAUSE
ANOTHER DOCTOR FILED IT ON DAY ONE PLUS 364 AND GOT PAID THAT NOW YOU HAVE THIS RE-SET
OF THE STATUTE OF LIMITATIONS AS IT APPLIES TO A COMPLETELY DIFFERENT DOCTOR. OLDFIELD
DIRECTLY ADDRESSES THIS AND SAYS IT'S WHAT'S WITHIN YOUR KNOWLEDGE. IT'S WHAT'S WITHIN
THE WORKER'S KNOWLEDGE. SO THE DOCTOR DOESN'T KNOW WHAT OTHER CLAIMS ARE PENDING. THE
DOCTOR DOESN'T KNOW WHETHER THERE'S A PENDING ACTION BY THE -- THEIR PATIENT, THE EMPLOYEE
AND THINGS OF THAT NATURE. THEY DON'T KNOW THAT. WHAT THEY DO KNOW -- JUSTICE
SOLOMON: DON'T DOCTORS KNOW THAT WHEN THEY THINK THERE'S A WORK-RELATED INJURY THEY WOULD
KNOW THERE'S GOT TO BE TWO YEARS. IT SOUNDS LIKE YOU'RE MAKING THE ARGUMENT FOR THE APPELLANTS
THAT IF EVERYBODY KNOWS WORK RELATED, YOU BETTER FIND OUT, YOU'VE GOT TWO YEARS, THEY KNOW
IT'S TWO YEARS. APPELLANT2: I THINK APPELLANT's ARGUMENT WAS REMARKABLY
IN MEDICAL PROVIDER OFFICES AND THERE'S THIS INTER AKDZ THAT THEY'RE TREATING A SMALL
SUBSET OF PATIENTS AS OPPOSED TO A LARGE NUMBER OF PATIENTS, THAT THEIR ADMINISTRATIVE
STAFF IS COMMUNICATING ON A DAILY BASIS AND THAT ALL THEIR SYSTEMS REPORT OUT AND GIVE
THEM ALL THIS INFORMATION. IT'S A REMARKABLE AMOUNT OF INFORMATION THAT MEDICAL PROVIDERS
ARE BEING IMPLIED TO ALREADY KNOW. AND OLDFIELD DEALS WITH THIS WHEN THEY SPECIFICALLY
SAY WHAT'S WITHIN YOUR KNOWLEDGE. SO IF YOU KNOW YOU FILED A CLAIM SIX YEARS AGO AND
IT WAS DENIED THE SEX DAY, YOU HAVE SIX YEARS FROM THAT DATE TO FILE THAT CLAIM. YOU
WAIT SIX YEARS AND A DAY YOU'RE OUT. THERE'S A WHOLE LOT OF INFORMATION THAT'S BEING
IMPLIED AND ASKED OF THE MEDICAL PROVIDERS TO FIGURE OUT ON HOW TO WORK WITH A STATUTORY
SCHEME. WITH A STATUTE OF LIMITATIONS, A JURISDICTIONAL ISSUE, WHERE THERE'S NO CLEAR
EVIDENCE BY THE LEGISLATURE THAT THAT WAS THE INTENT. THAT IT WAS THE INTENT OF THEM
TO, HEY, FROM NOW ON, ON THESE NINE DIFFERENT TIMES OF CLAIMS, FIGURE OUT WHAT THE STATUTE
OF LIMITATIONS IS. CALL THESE PEOPLE UP. ASK FOR THIS INFORMATION. GATHER THIS MATERIAL
AND DO THESE THINGS. THAT IS A REMARKABLE AMOUNT THAT'S BEING ASKED OF THE MEDICAL PROVIDERS,
BUT TO WHAT END? IF THE LEGISLATURE WANTED THIS TO HAPPEN, THEY WOULD HAVE SAID, MEDICAL
PROVIDERS OR CLAIMANTS, MAKE IT WORK. MAKE IT WORK. BY THE WAY, I BELIEVE THERE'S A
BILL CURRENTLY PENDING DESIGNED TO TRY TO CHANGE THIS NOW. AND -- CHIEF JUSTICE
RABNER: CAN YOU PLEASE DRAW YOUR ARGUMENT TO A CLOSE? APPELLANT2: YES.
SO I THINK THERE'S A BILL EXISTING NOW ON THIS ISSUE AND WHETHER OR NOT IT PASSES
LEGISLATURE WE'LL SEE. BUT I THINK WHAT'S BEING ASKED OF THIS COURT IS TO ESSENTIALLY
TAKE FOR NO REAL CLEAR REASON AN UN-CLEAR, IMPLIED INTENT OF THE LEGISLATURE, WHICH WILL
UPSET SUPREME COURT PRECEDENCE AND WILL CHANGE ESSENTIALLY THE FACE OF WHAT EXISTS TODAY
THROUGH OLDFIELD, THROUGH RABINOWITZ, ALL ALL THESE CASES, THE STATUTES, SOLELY TOE TAKE
THE STUMTHS AND SHRINK IT TO HERE, NOT REALLY HERE, BUT MAYBE HERE AND MAYBE MOVE IT
A LITTLE AROUND, WHEN THE REALITY IS THAT THERE'S SUCH CLARITY HERE THAT THE EMPLOYER HAS
AN AUCTION -- THE PHYSICIAN AGAINST THE EMPLOYEE OR THE EMPLOYER AND THAT CAUSE OF ACTION
SOUNDS IN CONTRACT AND THERE IS A CLEAR STATUTORY -- STATUTE OF LIMITATIONS THAT'S SET
AND THAT IS SIX YEARS AND THAT'S WHAT SHOULD BE APPLIED TO THE MEDICAL PROVIDERS IN THEIR
APPLICATION FOR REIMBURSEMENT. CHIEF JUSTICE RABNER: THANK YOU. MR.
KENDALL, A BRIEF REBUTTAL? AND IF YOU COULD PLEASE ADDRESS WHAT CLAIMANT FOR COMPENSATION
UNDER SECTION 51 REFERS TO. APPELLANT: I'LL START WITH THAT, AS JUSTICE
ALBIN POINTED OUT AND AS COUNSEL CONCEDED, CLAIMANTS IS A BROAD TERM USED IN SECTION 51.
AND IT COVERS ALL CLAIMANTS. IT'S NOT LIMITED TO JUST INJURED WORKERS. THERE'S NO
UNDERSTANDING IN THE DIVISION THAT IT JUST APPLIES TO INJURED WORKERS. ANYBODY WHO CAN
FILE A CLAIM IN THE DIVISION OF WORKER'S COMPENSATION IS A CLAIMANT. THAT'S A PIP
CARRIER. THE DECEASED SPOUSE. I'VE SAID THIS BEFORE SO I WON'T REPEAT IT. BUT I'LL
POSE A QUESTION TO THE COURT. IF A MEDICAL PROVIDER ISN'T A CLAIMANT, WHAT IS IT?
THERE'S NOTHING CARVED OUT IN THIS LEGISLATION THAT CREATES A SEPARATE CATEGORY FOR MEDICAL
PROVIDERS. THEY'RE CLAIMANTS IN THE DIVISION OF WORKER'S COMPENSATION AND UNDER THE
PROVISIONS OF THE ACT. SO I DON'T THINK THAT THAT CAN BE REASONABLY DISPUTED BY ANYBODY.
I DO WANT TO MENTION OLDFIELD. I DON'T THINK IT MEANS WHAT COUNSEL THINKS
IT MEANS. OLDFIELD WAS A DECISION ABOUT WHEN AN INJURED WORKER CAN FILE HIS OR HER CLAIM.
IT DIDN'T APPLY TO WHEN A MEDICAL PROVIDER CAN FILE A CLAIM AGAINST AN EMPLOYER. THE
LANGUAGE THAT COUNSEL IS RELYING ON IS IN-DICTA BY THE COURT, TALKING ABOUT THE HIEJ KAL
SITUATION, HOW WOULD A WORKER KNOW THIS, HOW WOULD A WORKER KNOW THAT. I'M GOING TO TURN
THE COURT TO PAGE 65 WHERE THE IN-DEDUCT TAKE STARTS. I DO LIKE ONE SENTENCE FROM OLDFIELD
WHICH I THINK IS PROBABLY HELPFUL FOR PURPOSES OF SOME OF THE THINGS WE DISCUSSED HERE.
THIS COURT SAID IN OLDFIELD, WE'RE OF THE OPINION THAT THE FURNISHING OF MEDICAL TREATMENT
IS IN THE NATURE OF COMPENSATION CH IT'S PRETTY CLEAR THAT CLAIMANTS WHO ARE SEEKING
REIMBURSEMENT OR ADDITIONAL PAYMENT OF MEDICAL PROVIDERS ARE SEEKING COMPENSATION IN THE
DIVISION OF WORKER'S COMPENSATION. JUSTICE ALBIN: YOU DON'T LIKE THE SENTENCE
THAT SAYS THE EMPLOYER IS LIABLE THAT ONE YOU DON'T LIKE? APPELLANT: I DON'T
PARTICULARLY HAVE ANY FEELINGS ABOUT IT. IT'S JUST NOT -- IT'S JUST NOT WHAT THE HOLDING
OF THE COURT WAS. THE HOLDING OF THE COURT WAS A DISMISSAL OF AN AWARD OF BENEFITS TO
AN INJURED WORKER BECAUSE OF THE TIMETABLES INVOLVED. JUSTICE ALBIN:
YOU'VE SAID IN SOME CASES, YOU KNOW, EVERYONE HAS TO RESPECT OUR DICTA. WE DON'T SAY THINGS
FOR NOTHING. APPELLANT: I UNDERSTAND THAT. AND I DID RESPECT THE COURT'S
DICTA. I JUST DON'T THINK IT'S APPLICABLE IN THIS CASE. THE OTHER THINGS
THAT I REALLY WANTED TO BRIEFLY MENTION. JUSTICE LAVECCHIA, YOU ASKED ABOUT WHETHER THE
DIVISION CAN DETERMINE -- IS THE SOLE DETERMINER OF COMPETENCE SABLT. IT IS NOT. IT
HAS PRIMARY JURISDICTION BUT THE SUPERIOR COURT CAN MAKE THAT. JUSTICE SOLOMON, YOU TALKED
ABOUT THE NATURE OF THESE CLAIMS, BY AND LARGE THE CLAIMS, NOT JUST THE FIVE YEARS, CLOSE
TO 90 PERCENT OF THE CLAIMS ARE MEDICAL PROVIDERS ASKING FOR MORE MONEY. THEY'VE BEEN
COMPENSATED. THEY JUST WANT MORE. THE THING I WANTED TO CLOSE WITH IS, AND
THIS HAS BEEN ALLUDED TO. REQUIRING MEDICAL PROVIDERS TO ADHERE TO THE SAME RULES,
TIMETABLES, PROCEDURES, IS NOT AN UN-REASONABLE REQUEST. IT MAKES ABSOLUTE SENSE THAT
THE MEDICAL PROVIDERS HAVE TO PLAY BY AND ADHERE TO THE SAME RULES AS PIP CARRIERS, AS
DEPENDENT SPOUSES AND AS THE INJURED WORKERS THEMSELVES. WE HAVE TO REMEMBER THAT THE
WORKER'S COMPENSATION ACT IS A CAREFULLY CRAFTED SCHEME THAT'S SUPPOSED TO BENEFIT THE
INJURED WORKERS. WE CAN'T LOSE SIGHT OF THE FACT THAT THE INJURED WORKERS SHOULD BE PARAMOUNT
TO THIS. LETTING MEDICAL PROVIDERS HAVE DIFFERENT RULES, HAVE EXTENDED PERIODS OF
TIME, THAT MAY IMPOSE UPON THOSE INJURED WORKERS RIGHTS GETTING THEIR CASES HEARD, SETTLED
OR HAVING IT BE BROUGHT BACK TO COURT SO THAT A MEDICAL PROVIDER CAN TRY TO PROVE A CLAIM
SIX YEARS LATER IS CONTRARY TO THE LEGISLATION THAT THE BANK OF AMERICA WORKER'S COMP
IS SUPPOSED TO BE. CHIEF JUSTICE RABNER: THANK YOU ALL COUNSEL FOR THE VERY
FINE ARGUMENTS WE'LL TAKE THE MATTER OF THE ADVISEMENT.