An influx of new medical provider claims in New Jersey Workers’ Compensation Court is imminent following a recent decision by the Supreme Court of New Jersey.  On February 3, 2020, the Supreme Court of New Jersey issued a decision affirming the judgment of the Appellate Decision that the applicable statute of limitations for medical provider claims in New Jersey Workers’ Compensation Court is six years as opposed to the previously commonly applied two-year statute of limitations.  457 N.J. Super. 565 (App. Div. 2019).  

In 2012, the legislature wrote Amendments to the New Jersey Workers’ Compensation Act which granted sole discretion to the New Jersey Division of Workers’ Compensation for disputes regarding medical provider fees arising out of treatment for work injuries.  Prior to the 2012 Amendments, those same disputes were litigated in civil court using the six-year statute of limitations applicable to contract claims.  However, the only statute of limitations used in the New Jersey Division of Workers’ Compensation had been the two years given to injured workers.  This led to a question left silent by the legislature in the 2012 Amendments of whether the six-year statute of limitations would continue to apply to these medical provider fee disputes or whether they would now conform to the two-year statute of limitations applied to workers’ compensation cases.

Dominic LaFauci, an attorney in the firm’s Mt. Laurel office, argued on behalf of the Respondent for the underlying workers’ compensation decision that was eventually appealed all the way up to the Supreme Court of New Jersey for this opinion.  In that case, a medical provider filed a claim that they were underpaid for treatment provided to the petitioner for the work injury.  It was clear that over two years had passed since the medical treatment at issue and the corresponding payment for that treatment had occurred.  It had even been over two years since any medical treatment or payment was made pursuant to the work injury.  Mr. LaFauci filed a Motion to Dismiss the medical provider claim for failure to comply with the two-year statute of limitations applicable in the New Jersey Division of Workers’ Compensation.

Both parties filed briefs and the Workers’ Compensation Judge agreed with Mr. LaFauci’s Motion and entered an Order dismissing the medical provider claim for failure to comply with the two-year statute of limitations.  The attorney for the medical provider appealed that decision and eventually that case was consolidated with others involving the same issue with various insurance companies and defense firms.  The Appellate Division reversed and remanded the decision of the Workers’ Compensation Judge.  The Appellate Division held that the six-year statute of limitations continued to apply to medical provider fee disputes even after the 2012 Amendments to the New Jersey Workers’ Compensation Act.  Their primary reasoning behind the decision was that they did not interpret legislative silence to restrict these medical provider fee disputes to a two-year statute of limitations applicable to claimants.  The Supreme Court of New Jersey affirmed the decision of the Appellate Decision and stated that:

• “The Appellate Division interpreted that silence to reveal the Legislature’s likely intent to leave things as they were. 457 N.J. Super. 571 (App. Div. 2019).  It was well-established long before the 2012 amendment that the timeliness of medical-provider claims was governed by the general six-year statute of limitations. Ibid. The appellate court reasoned that, had the Legislature intended to drastically alter that principle, it would have done so directly, not inferentially. Ibid. The court found support for that view in the legislative history of the 2012 amendments. Id. at 571-72.”

As of this decision on February 3, 2020, medical providers will be able to file claims disputing fees paid for treatment pursuant to compensable work injuries using a six-year statute of limitations.  Before this decision, the most common practice in the New Jersey Division of Workers’ Compensation was to use the two-year statute of limitations for all cases.  It now stands to reason that insurance carriers, employers, and defense firms should prepare for a flood of medical provider claims that would have previously failed to comply with a two-year statute of limitations.  The legislative silence has now been clearly articulated by the Supreme Court of New Jersey following this decision.