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Court Rulings

Plaintiff Linda Brehme appealed a trial court in limine ruling barring her claim for future medical expenses. She had sued defendants Thomas Irwin and New Jersey Manufacturers Insurance Company for personal injuries resulting from an automobile accident. The issue in Brehme v. Irwin, 2023 N.J. Super. Unpub. LEXIS 2401 (App. Div. Dec. 27, 2023) was whether the signed warrant to satisfy judgment barred her ability to appeal the trial court judge’s in limine ruling denying her claim for future medical expenses.

After discovery was completed in this matter, the case proceeded to trial. On the first day of trial, the judge heard an in limine motion by defendant to bar plaintiff’s claim for future medical expenses. The judge determined that plaintiff’s personal injury protection coverage under her automobile insurance policy was not exhausted and, hence, barred as speculative any claim by plaintiff for future medical expenses.

The case was tried before a jury, which awarded plaintiff the sum of $225,000 for pain and suffering and $50,000 for lost wages. After adding interest and costs, the judge entered a judgment. Thereafter, plaintiff’s counsel signed a warrant to satisfy judgment. There was nothing in the warrant that indicated plaintiff’s intent to appeal the judge’s in limine ruling denying her claim for future medical expenses. The judgment was paid and the signed warrant to satisfy judgment was entered on the court’s docket. Thereafter, plaintiff filed this notice of appeal.

The plaintiff argued that the judge made a mistake in denying her claim for future medical expenses. In her appeal, she sought a new trial limited to this issue. She further argued that she was not precluded from proceeding with her appeal, notwithstanding the warrant to satisfy judgment.

The Appellate Division rejected that argument. It noted the well settled law that “a litigant who voluntarily accepts the benefits of a judgment is estopped from attacking it on appeal.” Here, the defendant elected not to appeal the judgment and agreed to pay the full amount to plaintiff in return for a warrant of satisfaction. The Court noted the case law that “where a party receives and accepts the judgment amount and the adverse party then files a warrant for satisfaction, such conduct expressly acknowledges the validity of the judgment and operates as a waiver of the right to appeal therefrom.”

The plaintiff never advanced, either on the record or in writing, that she intended to continue to pursue her claim for future medical expenses. She accepted and received the full judgment amount from the defendant New Jersey Manufacturers Insurance Company and a warrant to satisfy judgment. The Appellate Division held that the plaintiff’s receipt and acceptance of the full amount of the judgment precluded her appeal challenging the trial judge’s denial of future medical expenses. Thus, the Court dismissed the appeal as moot.

This matter arose from a tragic fire that occurred on April 8, 2021, at the three-story single-family residence owned by the defendant Newark Housing Authority and occupied by plaintiff Kadisha Jones Richardson and her five children.  Plaintiff Tyron Hartfield, the biological father of four of the five children, was also present at the time of the fire.  During the fire, plaintiffs’ seven-year-old son, Saahir, passed away.  Further family tragedies happened after the fire.  The issue in Richardson v. Newark Housing Authority, 2023 N.J. Super. Unpub. LEXIS 1119 (App. Div. July 5, 2023) was whether the trial court properly granted the plaintiffs’ motion for leave to file a late notice of tort claim to permit plaintiff to sue the Newark Housing Authority for losses suffered from the fire.  No tort claim notice had been filed in the required ninety (90) day time period following the loss.

In addition to the trauma of suffering the death of their son, Hartfield suffered a broken ankle in his attempt to rescue his son and the entirety of the family’s possessions were destroyed.  Plaintiffs and their family were forced to move in with Richardson’s mother.  During this time, Richardson was also caring for her mother, whose physical health was declining.  Less than three months after the fire, Richardson’s mother suffered a stroke and was hospitalized and ultimately passed away.  Further, Richardson was injured in a serious car accident.

In their motion for leave to file a late notice of tort claim, plaintiffs certified that in the months following the fire, they suffered from depression and anxiety from the loss of their son and their stress was further compounded by attending to the mental well being of their other children who had lost their brother and then Richardson’s mother.  Although plaintiffs received a death certificate on April 16, 2021, they still did not have the official cause of death or cause of the fire until November 2021.  On October 29, 2021, the plaintiffs had consulted a law firm for the first time.  However, on December 2, 2021, that law firm declined representation.

Plaintiffs retained their current counsel in March 2022.  Once counsel was retained, counsel promptly filed a motion for leave to file a late notice of tort claim on April 6, 2022, just two days shy of the one-year anniversary of the fire.  The trial court found that though plaintiffs did not file within the notice of tort claim within the required ninety (90) days of the accrual date, they did demonstrate extraordinary circumstances which permitted a late filing.  Specifically, the trial court found that there was excusable neglect on the part of the plaintiffs due to the extraordinary circumstances present.  The court found that the plaintiffs had suffered life-altering events and resulting psychological traumas which continued well beyond the ninety (90) days to file following the April 8, 2021 fire.  Thus, the trial court granted the motion to permit the late filing of the tort claim notice to permit the plaintiffs to pursue the Newark Housing Authority in a lawsuit.

The Newark Housing Authority appealed that order, arguing that there were no extraordinary circumstances present.  The Housing Authority argued that plaintiffs were physically capable of contacting an attorney in a timely fashion and should have done so at the earliest opportunity, irrespective of their constructive or actual knowledge of the ninety (90) day window for filing the notice of tort claim.

Upon appeal, the Appellate Division noted that for a claimant to pursue a claim against a public entity for personal injuries, it must file a notice of tort claim not later than the nineth (90th) day after accrual of the cause of action, pursuant to N.J.S.A. 59:8-8.  The date of accrual of a cause of action in tort is typically the date of the incident.  The penalty for failing to file a timely notice of tort claim is that the claimant is forever barred from bringing their claim against the public entity. 

However, the Court noted that the Act provides an exception to plaintiffs where the ninety (90) day period has lapsed and allows prospective claimants to file a motion within one year from the accrual of the cause of action “where they demonstrate extraordinary circumstances” to justify filing a late notice of tort claim.  Pursuant to the statute, the claimant must also demonstrate that the public entity has not been substantially prejudiced by the late notice.

The Appellate Division found that the trial court judge exercised “appropriate discretion” in determining extraordinary circumstances existed in the present facts.  The Court disagreed with the defendant’s argument that extraordinary circumstances equated to physical incapacity.  The Appellate Division noted that there was nothing in the statute or case law that required a plaintiff be physically unable to contact an attorney.  Although physical incapability may be sufficient to prove extraordinary circumstances, it is not a necessary pre-condition for a finding of extraordinary circumstances.  The Appellate Division noted that the trial judges are afforded a wide latitude in determining extraordinary circumstances.

Thus, the Court agreed with the trial court findings that extraordinary circumstances were present based upon the facts of the case.  Therefore, the Appellate Division affirmed the trial court decision, permitting the claim to move forward, based upon the strong public policy in favor of resolving the application on the merits. 

Liberty Insurance v. Techdan, LLC, (A-52-21) (086219), decided on February 15, 2023, is a case that practitioners, employers, third party administrators and insurance carriers should be aware of. It is the only New Jersey Supreme Court case which provides a comprehensive analysis of the New Jersey Insurance Fraud Prevention Act (IFPA) and the New Jersey Workers’ Compensation Fraud Act.

The main allegation in the case filed by Liberty Insurance was that Techdan, LLC and Exterior Erecting Services, Inc. misrepresented the relationship between their two companies and provided fraudulent payroll records in order to lower their workers’ compensation premiums.  Techdan was indicted for second degree theft by deception, and one of the company’s principals entered a guilty plea on Techdan’s behalf.

The fraud took place many years ago.  Liberty Insurance issued a workers’ compensation policy to Techdan from March 12, 2004 to March 12, 2007.  During its underwriting and audit process, Liberty alleged that the defendant companies misrepresented their relationship between Techdan and Exterior and provided Liberty’s auditors with fraudulent payroll records in order to reduce the premiums charged by Liberty Insurance.   

After the criminal matter resolved with a plea agreement for second degree theft by deception, Liberty Insurance pursued a civil action under the IFPA and under the NJ Workers’ Compensation Fraud Act.  Liberty Insurance argued that the Court should pierce Techdan’s corporate veil and Exterior’s limited liability company veil to impose personal liability on the officers and directors of the companies.

The trial court ultimately found that all defendants should be jointly and severally liable for treble damages under the IFPA.  The result was that an award of $756,990 was trebled to $2,270.970, as the IFPA (unlike the New Jersey Workers’ Compensation Fraud Act) provides for treble damages.  The trial court also entered judgment for trebled attorney fees in the amount of $2,768,018.  Costs were also trebled in the amount of $290,048.

In the Supreme Court opinion, several aspects of the decision were appealed, one of which was whether joint and several liability should apply under the New Jersey Comparative Liability Law.  Those aspects of the case are not relevant to the focus of this blog and will not be addressed here.  Suffice to say that the Supreme Court found that the trial court should have charged the jury to allocate percentages of fault among the various defendants.

The two fraud acts have different primary emphasis but one key area of overlap.  The Insurance Fraud Prevention Act found at N.J.S.A. 17:33A, focuses on alleged fraudulent written and oral statements made by businesses to obtain a policy of insurance or in connection with a claim made to the Unsatisfied Claim and Judgment Fund.

The New Jersey Workers’ Compensation Fraud Act, found at N.J.S.A. 34:15-57.4, focuses mostly on an individual’s false or misleading statements concerning any fact that is material to a claim for workers’ compensation benefits for the purpose of wrongfully obtaining those benefits.

The area of overlap involves the kind of fraud alleged in Liberty Insurance.  Both laws prohibit misclassification of employees for the purpose of evading the full payment of benefits or premiums under the New Jersey laws.

It is interesting to compare the two laws in terms of remedies.  Both allow civil actions, but the New Jersey Workers’ Compensation Fraud Act allows the Judge of Compensation to make findings on fraud,  order the dismissal of a case or a particular claim for fraud, and order repayment of benefits plus simple interest.  The IFPA provides for treble damages to the prevailing party but treble damages are not available in the NJ Workers’ Compensation Fraud Act.  Both the IFPA and the NJ Workers’ Compensation Fraud Act provide for an award of reasonable costs and attorney fees to the prevailing party.

The New Jersey Workers’ Compensation Fraud Act states in Section 34:15-57.4 b. “Any person who wrongfully obtains benefits or evades the full payment of benefits or premiums by means of a violation of the provisions of subsection a. of this section shall be civilly liable to any person injured by the violation for damages and all reasonable costs and attorney fees of the injured person.”

The Workers’ Compensation Fraud Act also adds that if a person receives benefits “to which the person is not entitled, he is liable to repay that sum plus simple interest to the employer or carrier or have the sum plus simple interest deducted from future benefits payable to that person, and the division shall issue an order providing for the repayment or deduction.”  

The burden of proof in a fraud case brought by an employer, third party administrator or carrier is on the moving party.   When an employer brings a motion for a potential finding of fraud under the New Jersey Workers’ Compensation Fraud Act, there are two key elements of proof:  1) proof of a false or material misrepresentation, statement or submission concerning a material fact; and 2) proof that the misrepresentation, false statement or submission was made for the purpose of wrongfully obtaining workers’ compensation benefits.

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On June 4, 2021, plaintiff Joshua Jackson slipped on an unidentified liquid on the stairs between the first and second floors of a building owned by Defendant City of Passaic Housing Authority.  Plaintiff alleges that he attempted to obtain a notice of claim form from the Authority but was unsuccessful. Less than one week before the ninety day Tort Claims Act deadline (to file a notice of claim) elapsed, plaintiff retained counsel who purportedly called the Authority and asked for a notice of claim form but was sent an incident report. The issue in Jackson v. City of Passaic Housing Authority, 2023 N.J. Super. Unpub. LEXIS 119 (App. Div. Jan. 27, 2023) was whether the plaintiff had shown sufficient reasons constituting extraordinary circumstances justifying his failure to timely file notice of his accident with the defendant Authority.

The facts appear to be somewhat disputed whether the plaintiff’s counsel called and asked for a notice of claim form or, rather, whether he simply asked for an incident report.  However, there was no dispute that the notice of tort claim was not filed until eight days past the ninety-day statutory deadline, as required under the Tort Claims Act.

The plaintiff filed a motion seeking leave from the trial court to file a late notice of claim.  The trial court denied this application, finding that N.J.S.A. 59:8-4 specifically enumerated what was supposed to be in the claims form.  Further, the court found that, even if the defendant Authority failed to provide plaintiff with a notice of claim form, that did not constitute extraordinary circumstances in the trial court’s view to justify missing the statutory deadline. (Accordingly, his claim was barred.)

Upon appeal, the Appellate Division noted that, pursuant to the Tort Claims Act, a public entity is not liable for an injury, except for as provided by the Act.  The Act provides that, prior to the filing of a formal complaint, a claimant must provide the public entity with a notice of claim no later than the ninetieth day after accrual of the cause of action.  That date would typically be the date the negligent conduct causing injury occurred.  Further, if a claimant fails to timely file a notice of claim with a public entity within this ninety-day time period, the claim is permanently barred.  The Court noted that the purpose of this deadline is to “compel a claimant to expose his intention and information early in the process in order to permit a public entity to undertake an investigation while witnesses are available and the facts are fresh.”

The Court further noted this ninety-day filing requirement is not completely inflexible and the claimant is permitted, in limited circumstances, to make a motion for leave to file a late notice of tort claim.  However, the motion must be “supported by Affidavits based upon personal knowledge of the affiant showing sufficient reasons constituting extraordinary circumstances for the failure to file the motion, and the public entity must not be substantially prejudiced by the late notice.”  It is up to the trial court to determine whether extraordinary circumstances exist.

Here, the plaintiff argued that the trial court failed to consider all the facts and circumstances surrounding the late claim by failing to consider the notice was only eight days late, plaintiff timely retained counsel, and a lack of prejudice to the Authority.

The Appellate Division, however, rejected this argument and agreed with the trial court that plaintiff failed to demonstrate extraordinary circumstances to justify his failure to file the notice of claim within the ninety day window.  The Court found that plaintiff was represented by counsel prior to the expiration of the applicable time period. 

According to the facts presented, the delay in filing was due to lack of due diligence, which the New Jersey Supreme Court has held is insufficient to establish permissible filing of a late notice.  Further, the Court stated that there is no standard “form” that must be filed.

Plaintiff failed to present any evidence, nor cited to any case law, statute, or regulation to support his position that he should be permitted to file an untimely notice because he was only slightly late.  The Appellate Division noted that the Legislature’s waiver of sovereign immunity remains a limited one and they are not free to expand that waiver beyond its statutorily established boundaries.  Hence the Appellate Division affirmed the trial court’s decision, denying the plaintiff’s motion to file a late notice of tort claim.

When coverage is denied under a workers’ compensation policy for an LLC, one can be almost certain that a finger will be pointed, rightly or wrongly, at the insurance broker.  The more severe the injury, the more likely the potential for a civil suit.  This was the situation in last month’s decision in Holm v. Purdy, New Jersey Supreme Court No. A-39-21 (Dec. 13, 2022).  Brokers will be interested in this case because it is a case of first impression and will change procedures with respect to those who work with members of an LLC.

The case arose from the death of member of an LLC.  As many know, an LLC must elect to obtain coverage for its members.  Otherwise, there is no workers’ compensation coverage for the members of the LLC.  The employees of an LLC, of course, are covered under workers’ compensation.

Holmdel Nurseries LLC had two members, Robert and Walter Friedauer, brothers in the business. Robert’s sons, Michael and Christopher, became full-time employees in the business after college.

When workers’ compensation coverage first became available in New Jersey for members of an LLC, Holmdel Nurseries elected to obtain coverage for Robert and Walter. Sometime later, the LLC decided against renewal of coverage due to the cost of workers’ compensation insurance.

For many years, the brothers retained Daniel Purdy as the broker for the LLC and for themselves personally.  When the LLC decided against maintaining workers’ compensation coverage for themselves as members, the policy stated, “Workers’ Compensation Members Excluded.”

In the Spring of 2012, Michael Friedauer and Christopher Friedauer purchased Walter Friedauer’s 50% interest in Holmdel Nurseries.  The sons were no longer employees in the business but now members of the LLC.  On July 12, 2012, a company meeting took place.  Purdy said he learned for the first time that Michael and Christopher were no longer employees and had become members of the LLC.  He admitted that he did not tell the sons that they were no longer covered under workers’ compensation by changing status from employees to members.  Nor did he tell the brothers that the LLC could elect to purchase workers’ compensation insurance for them.

On February 15, 2015, tragedy struck.  Michael Friedauer encountered his brother at the nursery.  He was covered in snow and appeared not to be himself.  Christopher said he had fallen and hit his head.  Christopher told his brother than he fell so hard that he saw stars.  Michael later that day looked for his brother and found him sitting dead in a truck on work premises.  Christopher’s wife filed a dependency claim petition on her behalf and on behalf of her two children asserting that her husband’s death arose from work.  The workers’ compensation carrier denied coverage as the LLC had not elected to provide coverage for the members.

A civil suit was filed by Christopher Friedauer’s widow against the broker Purdy asserting an act of professional negligence.  Robert and Michael Friedauer asserted that they did not know that they were not covered as members for workers’ compensation purposes and said that they would have elected coverage had they known it was available.

The trial court ruled against the widow and held that the broker had no duty to inform members of their right to elect workers’ compensation coverage. The Appellate Division reversed and the Supreme Court took certification. 

The starting point for the Supreme Court was an analysis of N.J.S.A. 34:15-36:

Notwithstanding any other provision of law to the contrary, no insurer or insurance producer . . . shall be liable in an action for damages on account of the failure of a . . . limited liability company . . . to elect to obtain workers’ compensation coverage for a . . . limited liability company’s members . . . unless the insurer or insurance producer causes damage by a willful, wanton or grossly negligent act of commission or omission. . .

The Supreme agreed with the conclusion of the Appellate Division and held:  “In accordance with N.J.S.A. 34:15-36, we hold that an insurance broker for an LLC, charged by the LLC to obtain workers’ compensation coverage on its behalf, has a non-waivable duty to provide notice that such coverage is available to LLC members who can actively perform services on behalf of the LLC – but that such coverage is available only if the LLC elects the coverage when the policy is purchased or renewed. Because it is foreseeable that the failure to provide such notice may harm an LLC member’s dependents, the broker’s duty extends not only to the LLC, but also to LLC members eligible for workers’ compensation coverage under N.J.S.A. 34:15-36.”

The Supreme Court remanded the matter to the trial court to determine whether the defendant ‘caused damage by a willful, wanton, or grossly negligent act of commission or omission.’

The post Supreme Court Finds Non-Waivable Duty on the Part of Insurance Brokers to Provide Notice of Available Coverage for LLC Members appeared first on NJ Workers' Comp Blog.

In Saiti v. Garden Homes, No. A-1328-20 (App. Div. October 11, 2022), the petitioner received an award for $66,074 on September 3, 2020.  The terms of the settlement were memorialized in an order signed by the Judge of Compensation and both parties. Petitioner’s attorney made numerous phone calls in the ensuing 60 days regarding non-payment of the order.  After 60 days, petitioner moved to enforce the Order since payments still had not been made.  Over 90 days after the Order was entered, a telephone conference occurred on December 7, 2020 regarding the late payment.  There was no record of the conversation and no record of any oral argument by the parties, although there is mention that the parties appeared.

On December 7, 2020, the Judge of Compensation issued an oral decision on petitioner’s motion, noting that the payments were now due over 90 days.  The Judge of Compensation ordered:

  1. Costs and interest on the settlement payments;
  2. An additional assessment of 25% of the monies due for the unreasonable payment delay to the petitioner with $16,287 payable to Saiti;
  3. $4,000 in attorneys’ fees payable to counsel for Saiti;
  4. $5,000 in penalties payable to the Second Injury Fund;
  5. Additional legal fees of $2,188 to counsel for Saiti in relation to enforcement efforts.

Respondent appealed the December 7, 2020 Order and argued that the Judge of Compensation abused his discretion in awarding penalties and sanctions without affording counsel the opportunity to be heard. 

The Appellate Division observed, “The Workers’ Compensation Act does not establish a specific timeframe for payment of workers’ compensation settlement proceeds.”  That statement is puzzling because N.J.S.A. 34:15-28 states as follows: “Whenever lawful compensation shall have been withheld from an injured employee or dependents for a term of 60 or more days following entry of a judgment or order, simple interest on each weekly payment for the period of delay of each payment may, at the discretion of the division, be added to the amount due at the time of settlement.” While this statute gives the Judge of Compensation some discretion, it also clearly refers to a 60-day time period.

The Appellate Division held, “Having reviewed the parties’ arguments in light of the record and the applicable legal principles, we are unable to determine whether the imposition of penalties and assessments under the December 7, 2020 order was reasonable.”

The Court held, “We are satisfied that it was a mistaken abuse of discretion to enter an order awarding sanctions without permitting counsel to be heard and without findings as to why the payment delay was unreasonable.”

The Court directed that the Judge of Workers’ Compensation “shall conduct a hearing and consider the steps taken by Saiti’s counsel to secure payment within sixty days of the entry of the September 7, 2020 order.” The Order was vacated pending a new hearing.  The case seems to turn on procedural due process, namely the need for the Judge of Compensation to hear oral arguments on the reasonableness of the delay, specifically whether the delay in payment had some justification.

This decision provides no comfort for respondents.  It is true that the December 7, 2020 Order was vacated, but a new hearing will be held in which the Judge of Compensation will hear oral arguments from defense counsel explaining the reason, if any, for delays in paying the Order of September 3, 2020.   The best advice to employers remains this:  all orders need to be paid within 60 days.  That is the clear import of the relevant statute.

Plaintiff Christopher Casucci was rear ended by the defendants’ commercial vehicle driven by defendant Kevin Valan and owned by Marascio Brothers Electric. The collision was a minor impact but plaintiff claimed to have suffered neck pain, headaches and tingling in his hands as a result of the accident.  The issue in Casucci v. Valan, 2022 N.J. Super. Unpub. LEXIS 1833 (App. Div. Oct. 5, 2022), was whether the jury’s verdict of zero damages should be upheld in light of the defendants’ stipulation to liability before trial.

At the time of the accident, plaintiff was wearing a seat belt and his body did not strike any part of the car.  He admitted that the impact was minor.  At the scene, he did not request an ambulance or any treatment.  He began seeing a chiropractor about one month later, who he had previously seen for low back pain.  He treated for three months and reported improvement.   He saw an orthopedist three times over a one year period and he had an MRI.  The orthopedist noted that the plaintiff’s cervical range of motion lacked five degrees but was otherwise “normal.”

Before the trial, the defendants admitted liability for causing the accident and stipulated that the only issue before the jury was whether or not the plaintiff was entitled to damages.  Both parties presented expert testimony concerning plaintiff’s injuries suffered in the accident.  While the plaintiff’s expert opined that the plaintiff injured his neck and suffered a disc herniation, on cross examination, he conceded that the plaintiff suffered from pre-existing arthritis which may have caused the herniation.  He could find no objective evidence of the tingling sensation that the plaintiff complained of in his hands for objective testing.  On the flip side, the defendants’ expert opined that the plaintiff suffered a soft tissue sprain.  He was also unable to find objective evidence of the tingling.  After he reviewed the MRI, he opined that the disc herniation was the result of the plaintiff’s longstanding degenerative disease and there was no evidence of a permanent injury caused by the accident.

At trial, plaintiff requested that the trial court judge grant a directed verdict on proximate cause.  He argued that both doctors testified that there are injuries in this case and that the proposed verdict sheet asked the jury only the quantum of damages, not proximate cause.  Plaintiff argued that the jury could not award zero damages because all of the evidence clearly demonstrated that there was an injury.

The defendants, however, argued that the jury could make credibility determinations of the witnesses and reject all the testimony and determine that there was no compensable injury.  They argued that the jury could conclude that there was an injury from the accident but it was not worth any amount of compensation. 

The trial court judge denied the request for a directed verdict.  He noted that, although defendants had stipulated to liability, their expert’s testimony was not dispositive of whether the plaintiff had suffered an injury.  The defense expert saw the plaintiff two years after the accident and his opinion was that “I think he has suffered a soft tissue strain of his cervical spine.”   

Upon appeal, the Appellate Division noted that given these “qualified statements, the trial court correctly found the jury was free to reject all or some of his testimony.” The Court found that proximate cause is ordinarily a fact issue to be resolved by a jury.  Further, it noted that there was sufficient evidence in the record to submit the question of whether plaintiff’s current physical condition was proximately caused by the accident.  Thus, the Court found that the trial court properly denied the motion for a directed verdict, allowing the issue to go to the jury.

The Appellate Division also noted that the defendants’ stipulation as to liability did not include a stipulation as to proximate cause or damages.  Further, the Court stated that “[a] jury is always at liberty to find that there are no compensable damages sustained as a result of the accident, even if both experts admit an injury was sustained.”  The Appellate Division found that a jury did have “substantial, credible evidence to determine plaintiff did not suffer compensable injury.”  The jury could reasonably determine that plaintiff suffered a mild injury that had resolved itself based upon the evidence presented. 

Further, it held that “a jury has no obligation to award positive damages where it has determined a plaintiff’s injuries, although they may never vanish, are not sufficiently pronounced to warrant financial recovery.” The Court stated that the law does not require a remedy for a de minimis harm.

In reviewing the evidence, the Appellate Division found that the jury’s award was reasonable.  It noted that there was a minimal impact based upon the dash cam video, the plaintiff was able to drive away and did not seek treatment for nearly a month, he had limited treatment after the accident, he had previous treatments with a chiropractor for back pain, both experts were unable to point to any objective evidence of a self-reported symptom, defendant’s expert opined that plaintiff’s injuries were caused by his degenerative disease and that plaintiff did not suffer permanent injury as a result of the accident. 

Thus, the Appellate Division ruled that the jury did have “an ample reasonable basis” to find that the plaintiff did not suffer a compensable injury due to the accident.  Thus, the Court found that the trial judge properly denied plaintiff’s motion for a directed verdict on proximate cause and properly submitted the issue to the jury for the jury to decide if plaintiff’s injuries merited compensation. 

Plaintiff’s deceased husband Bernard Waddell contracted COVID-19 in March 2020 while he was working as a Corrections Officer at the Hudson County Correctional Center.  He died from viral pneumonia secondary to COVID-19 on April 1, 2020.  Plaintiff, Sheliah Waddell, Bernard’s wife filed a Notice of Tort Claim in November 2020 and thereafter filed a motion for leave to file a late notice in March 2021.  The issue in Waddell v. County of Hudson, 2022 N.J. Super. Unpub. LEXIS 1320 (App. Div. July 21, 2022) was whether the plaintiff had presented extraordinary circumstances to warrant the late filing of a Tort Claim Notice.

Under the Tort Claims Act, N.J.S.A. 59:8-8, a plaintiff is required to file a Notice of Tort Claim upon a public entity not later than the ninetieth day after accrual of the cause of action.  The failure to serve such a notice of claim on a timely basis results in a bar against the claim and recovery.  Under these facts, the plaintiff’s cause of action accrued on April 1, 2020, the date of Bernard’s death.  It was undisputed that the Tort Claims Notice was not filed until well after the 90-day period.

The Tort Claims Act, however, does afford relief pursuant to N.J.S.A. 59:8-9, which allows a plaintiff to file a motion for leave to file a late notice within one year after the accrual of the claim.  The trial court may grant the motion if there are “sufficient reasons constituting extraordinary circumstances for the claimant’s failure to timely file” the Tort Claim Notice within the statutory mandate.  Also, the plaintiff must be able to show that the public entity was not substantially prejudiced thereby.  The trial court must undertake a fact sensitive analysis on a case by case basis to determine whether the plaintiff has presented extraordinary circumstances to justify the leave to file a late notice.

Case law has determined that the “extraordinary circumstances” standard for a late filing of a claim notice is a demanding one.  The court must look at the severity of the medical condition and the consequential impact on the claimant’s ability to seek redress and pursue a claim.

Here, the decedent’s wife, Sheliah, certified that her son was sick from COVID-19 from mid-April until the end of May 2020.  Further, she was grieving over the death of her husband during that time period and did not consider that her husband’s death may have been due to the fault of another until some months later.  She did not retain counsel to represent her in this action until October 2020.

However, the County had opened a workers’ compensation claim for Bernard on April 2, 2020.  The third-party administrator of Hudson County’s workers’ compensation program had a communications with the plaintiff in July, advising her that Bernard’s time card revealed he was exposed to coworkers and inmates who testified positive for COVID-19.  Further, Sheliah received reimbursement for funeral expenses and dependency benefits.  Also, the County Finance Department worked with Sheliah in May 2020 to assist her in obtaining several types of benefits available to the Estate.

The trial court determined that the plaintiff had shown sufficient reasons for her failure to timely file the Notice of Tort Claim.  The trial court considered the ongoing health crisis, Bernard’s death, and the illness of plaintiff’s son to be sufficient reasons for the late filing.

The Appellate Division disagreed.  The Appellate Division found that the facts did not present a situation so “severe, debilitating or uncommon” to prevent Sheliah from contacting an attorney and pursuing a claim.  The Court noted that Sheliah was “not incapacitated, confined to a hospital, or under a mental impairment as seen in other instances.”  Further, although she had certified that she had been concentrating on her ill son, she did not state that he was hospitalized or gravely ill, and, in fact, he recovered from his illness in May.

Further, immediately following Bernard’s death, Sheliah had communications with County employees regarding potential benefits relating to her husband’s death.  She was aware that he was exposed to COVID-19 while working for the County and that he died of complications from the disease.  While she may not have been aware that the defendant County could have any legal liability for Bernard’s death, the Court pointed out that the New Jersey Supreme Court has rejected knowledge of fault as an excuse for a late Tort Claim Notice filing.

The Appellate Division noted that, while it was sympathetic to Sheliah’s loss and the “unprecedented impact” of COVID-19, the circumstances did not meet the required high threshold to bring a claim under the Tort Claims Act.  Sheliah’s conduct in the 90 days following Bernard’s death confirmed that she could have contacted an attorney from her home, as she eventually did.

Thus, the Appellate Division found that the plaintiff could not demonstrate that extraordinary circumstances existed for the untimely filing of the Tort Claims Notice.  Hence, it reversed the trial court decision permitting leave to file a late notice of claim.  Accordingly, based upon this decision, the plaintiff would be barred in pursuing the County of Hudson for tort damages due to the death of her husband.

Plaintiff Jeffrey Wichot sued Defendant for emotional injuries suffered from a car kidnapping that occurred in 2012. Plaintiff had previously suffered a horrific injury as a young boy in 2002 which resulted in a traumatic brain injury. One of the issues in Wichot v. Allstate N.J. Prop. & Cas. Ins. Co., 2021 N.J. Super. Unpub. LEXIS 1020 (App. Div. May 27, 2021), was whether Plaintiff needed to provide a comparative analysis of his injuries suffered in the two incidents to be able to establish causation of his injuries incurred in the second incident.

In 2002, Plaintiff’s traumatic brain injury resulted in a severe closed-head injury, from which he continued to suffer and resulted in him being legally incapacitated. He had been riding a motorized scooter when he was struck by a van and propelled 20 feet, striking his head on the concrete road.

In 2012, the subject of this lawsuit, Plaintiff was kidnapped from his own car, driven around, slapped around, and threatened with a gun. Ultimately, there was an accident in which the driver hit a wall and Plaintiff escaped from the car. Plaintiff’s treating doctor opined that he suffered PTSD from this assault incident, which worsened Plaintiff’s pre-existing cognitive and emotional injuries from his brain injury suffered from the 2002 incident. Further, his doctor opined that the assault caused permanent emotional damage to his functioning, which was qualitatively and quantitatively different than his symptoms before the assault.

Defendant filed for a summary judgment, arguing that Plaintiff had failed to provide a comparative analysis of the injuries between the two incidents, so as to “give the jury guidance… as to what … psychological and emotional injuries [were] attributable to this accident.” The trial court judge granted the motion and dismissed the lawsuit, finding that Plaintiff’s treating doctor failed to provide a proper allocation of injuries suffered between the two accidents and, thus, the jury’s decision would be “purely speculative as to what psychological and emotional injuries are attributable to this accident.”

The Plaintiff appealed this decision to the Appellate Division, arguing that he did not plead aggravation of a pre-existing injury in his complaint and, therefore, to establish causation of injuries caused by the second accident, he was not required to provide a comparative analysis of injuries suffered in the two incidents to survive a summary judgment motion. While Defendant conceded that aggravation was not pled in the Complaint, Defendant argued that it was acknowledged through Plaintiff’s response to interrogatories and in his treating doctor’s report.

The Appellate Division noted that, Plaintiff’s claim was subject to the verbal threshold, N.J.S.A. 39:6A-8(a). Under prior case law (referred to as a “Polk” analysis), when a plaintiff alleges an aggravation of a pre-existing injury or condition, he must produce comparative evidence to move forward with the causation element of his tort claim. However, when Plaintiff does not plead aggravation of a pre-existing injury, this comparative analysis is not required.

Here, Plaintiff’s claim was that the assault caused “a separate and distinct injury,” and Plaintiff did not plead an aggravation from the 2002 incident. His treating doctor opined that he suffered PTSD from his 2012 incident. However, his doctor’s report did mention an exacerbation of his prior traumatic brain injury and Plaintiff’s response to Defendant’s interrogatory as to prior disability stated that the assault “severely exacerbated” his prior injury.

The Appellate Division found those statements made in his doctor’s report and in answers to discovery were insufficient to trigger a Polk analysis. Regardless, the Court found that the Defendant may produce evidence that the Plaintiff’s injury was caused, wholly or in part, by an earlier accident or pre-existing condition. Based on the treating doctor’s report, there were disputed issues of fact about whether this accident caused Plaintiff’s permanent injury. Further, the Court held that “even if defendant is correct that aggravation of a prior injury is part of this case – which plaintiff contends is inaccurate – then that aspect of the proofs would become a matter of proximate cause for the jury.”

Hence, the Appellate Division reversed the trial court’s grant of summary judgment and remanded the matter back for trial.

The case of Donald Servais v. Ocean Wholesale Nursery, LLC., A-2988-20, (App. Div. July 14, 2022) presents an unusual legal issue in workers’ compensation.  The case involved a dispute about an employment separation agreement and whether that agreement could have been construed to constitute a payment of workers’ compensation benefits, thereby tolling the statute of limitations.

Mr. Servais suffered an amputation of three fingers of his right hand on January 26, 2016.  No claim petition was ever filed within the two-year statutory period, and respondent never paid any workers’ compensation benefits to Mr. Servais, believing that the injury occurred at petitioner’s home and that petitioner was not an employee.  Respondent hired petitioner as a consultant and not as an employee, although petitioner contended that over the course of five years his relationship with Ocean Wholesale Nursery, LLC changed to that of an employee.  Petitioner ultimately filed a formal claim petition on October 26, 2018, well past the two year statute of limitations.

Respondent, as insured by Farm Family Insurance Company and administered by ESIS, filed a motion to dismiss the claim petition under the two year statute of limitations.  Petitioner countered by raising an argument regarding an employment separation agreement signed on January 31, 2017 by both parties by which terms respondent paid $5,000 to petitioner to resolve their business relationship.  Petitioner argued that the employment separation agreement was ambiguous and could have led petitioner to believe that the $5,000 payment was in part a payment for the loss of his fingers. Petitioner argued that the claim petition was filed within two years of the date of signing the employment agreement and was therefore timely filed.

The parties agreed to try the issue of the statute of limitations separately and then reserve for a later trial all other issues, such as compensability and employment.  The judge heard testimony from petitioner, the Nursery’s owner, and the Nursery’s former general manager.  The judge reviewed the terms of the employment separation agreement and found Section 7 of the Agreement to be confusing. That section excluded from the Agreement “claims that may arise after the date (petitioner) signs this agreement.”  The judge thought that this language might lead petitioner to believe that any incidents that arose before he signed this Agreement were included.   The judge also found paragraph seven to be ambiguous because it excluded “(petitioner’s) rights to receive benefits for occupational injury or illness under the workers’ compensation law” but did not specifically mention a “traumatic injury.”  The judge acknowledged that there was no mention anywhere in the agreement of an injury to petitioner’s fingers but criticized the agreement for not informing petitioner of his right to file a workers’ compensation claim.

Based on his interpretation of the separation agreement the judge concluded that the separation agreement included any and all claims, including the loss of fingers.  The judge also found that petitioner was an employee and was injured during the course of employment, although the judge previously agreed that these issues would be held for a later hearing.  Finally, the judge apportioned $1,000 of the $5,000 paid under the separation agreement to the petitioner’s injury to his fingers.

Farm Family appealed the decision to the Appellate Division, which reversed in favor of Farm Family and vacated the substantial award to petitioner.  The Court said, “Reviewing the Agreement de novo, we perceive no ambiguity.  The plain language of the Agreement expressly excluded petitioner’s workers’ compensation claim.” The Court added:

Contrary to petitioner’s argument, paragraphs five and six of the Agreement would not reasonably lead a person to believe that the $5,000 payment under the Agreement was also a partial payment for his work-related injury because paragraph seven of the Agreement, clearly entitled in bold ‘Exceptions,’ expressly stated that the release in the Agreement did not ‘affect or limit’ his right to receive benefits for occupational injury under the Workers’ Compensation Law.

In the end, the Appellate Division held that petitioner failed to file his claim petition in time. The Court also added that the Judge of Compensation had no right to apportion $1,000 of the $5,000 payment under the separation agreement to the loss of petitioner’s fingers.  The Court said:

The judge’s finding that $1,000 of the $5,000 payment of the agreement was payment for petitioner’s loss of fingers has no basis in the record evidence. The judge faulted the agreement for not addressing petitioner’s loss of his fingers and for failing to inform petitioner of ‘his right to file a workers’ compensation claim and his inability to waive same.’ Yet, in the Agreement, petitioner did not waive his right to file a workers’ compensation claim. To the contrary, in the Agreement, petitioner expressly reserved his right to file a workers’ compensation claim.  He just didn’t do so timely.

The Court concluded by reversing the order denying respondent’s motion to dismiss and vacated the final judgment.  The Court did not reach respondent’s argument regarding denial of due process given the decision to dismiss the case on the statute of limitations.

This trial and legal brief in this case were handled by former Capehart attorney Dana Gayeski, Esq. and the appeal was argued by John Geaney, Esq.

The post Appellate Division Reverses Judge of Compensation’s Decision That Employment Separation Agreement Constituted a Payment for a Disputed Workers’ Compensation Claim appeared first on NJ Workers' Comp Blog.

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