ATLA – NJATLA – NJ

FIVE CONCURRENT SEMINARSFIVE CONCURRENT SEMINARS

DECEMBER 2, 2006DECEMBER 2, 2006

WORKERS’ COMPENSATIONWORKERS’ COMPENSATION

THIRD PARTY ACTIONS ANDTHIRD PARTY ACTIONS AND

STATE DISABILITY LIENSSTATE DISABILITY LIENS

GREENBERG, WALDEN & GROSSMAN, L.L.C.GREENBERG, WALDEN & GROSSMAN, L.L.C.

PRESENTED BY:PRESENTED BY:

RANDY GROSSMAN, ESQ.RANDY GROSSMAN, ESQ.Greenberg, Walden & Grossman, L.L.C.Greenberg, Walden & Grossman, L.L.C.

randy@greenberg-walden.comrandy@greenberg-walden.com

201-854-2200201-854-2200

GREENBERG, WALDEN & GROSSMAN, L.L.C.GREENBERG, WALDEN & GROSSMAN, L.L.C.

The Department of Labor established new rule: The Department of Labor established new rule: N.J.A.C. 12:235-3.16 (effective Sept. 18, 2006)N.J.A.C. 12:235-3.16 (effective Sept. 18, 2006)

The rule codifies procedures for handling The rule codifies procedures for handling cases where claimant pursues temporary cases where claimant pursues temporary disability benefits under both the disability benefits under both the Temporary Disability Benefits Law (N.J.S.A. Temporary Disability Benefits Law (N.J.S.A. 43:21-25 et seq.) and the Workers’ 43:21-25 et seq.) and the Workers’ Compensation Act.Compensation Act.

N.J.S.A. 43:21-30 prohibits the payment of N.J.S.A. 43:21-30 prohibits the payment of temporary disability benefits for the same temporary disability benefits for the same period of disability under both TDBL and period of disability under both TDBL and WCA, a concept referred to as “non-WCA, a concept referred to as “non-duplication of benefits.” duplication of benefits.”

Where a petitioner’s claim for Where a petitioner’s claim for temporary disability benefits under temporary disability benefits under the WCA is contested (i.e., where the the WCA is contested (i.e., where the work relatedness of the disability for work relatedness of the disability for which the claimant is seeking which the claimant is seeking temporary disability benefits has yet temporary disability benefits has yet to be determined), the Division of to be determined), the Division of Temporary Disability Insurance or Temporary Disability Insurance or the private plan carrier may pay the private plan carrier may pay benefits.benefits.

Where workers’ compensation benefits are Where workers’ compensation benefits are subsequently awarded for weeks with subsequently awarded for weeks with respect to which the claimant has received respect to which the claimant has received benefits under the TDBL, the Division of benefits under the TDBL, the Division of Temporary Disability Benefits or the Temporary Disability Benefits or the private plan carrier is entitled to be private plan carrier is entitled to be subrogated to the extent of temporary subrogated to the extent of temporary disability paid.disability paid.

““Non-duplication of benefits” and “right of Non-duplication of benefits” and “right of subrogation” govern the interaction subrogation” govern the interaction between the two disability programs between the two disability programs where there is concurrent jurisdiction of where there is concurrent jurisdiction of two divisions of the Department of Labor.two divisions of the Department of Labor.

Prior to the enactment of N.J.A.C. 12:235-Prior to the enactment of N.J.A.C. 12:235-3.16, there was no procedure 3.16, there was no procedure memorialized in the law – the method memorialized in the law – the method traditionally employed by the Division of traditionally employed by the Division of Workers’ Compensation and the Division Workers’ Compensation and the Division of Temporary Disability was based on of Temporary Disability was based on various, long-standing practices.various, long-standing practices.

N.J.A.C. 12:235-3.16 sets forth a uniform N.J.A.C. 12:235-3.16 sets forth a uniform procedure to be followed by both the procedure to be followed by both the Division of Temporary Disability Insurance Division of Temporary Disability Insurance and the Division of Workers’ and the Division of Workers’ Compensation where the petitioner is Compensation where the petitioner is pursuing temporary disability benefits pursuing temporary disability benefits under both TDBL and the WCA.under both TDBL and the WCA.

Non-Duplication of Benefits under the Non-Duplication of Benefits under the Temporary Disability Benefits Law and the Temporary Disability Benefits Law and the Workers’ Compensation Act; Temporary Workers’ Compensation Act; Temporary Disability Benefits Liens in Workers’ Disability Benefits Liens in Workers’ Compensation Cases: Compensation Cases: N.J.A.C. 12:235-3.16N.J.A.C. 12:235-3.16

(a) Administrative procedures for avoiding (a) Administrative procedures for avoiding duplication of benefits in cases where claimants duplication of benefits in cases where claimants have pursued temporary disability benefits under have pursued temporary disability benefits under both the Temporary Disability Benefits Law, both the Temporary Disability Benefits Law, N.J.S.A. 43:21-25N.J.S.A. 43:21-25 et seq. (hereinafter referred to in et seq. (hereinafter referred to in this section as the "TDBL") and the Workers' this section as the "TDBL") and the Workers' Compensation Act, Compensation Act, N.J.S.A. 34:15-1N.J.S.A. 34:15-1 et seq. et seq. (hereinafter referred to in this section as the (hereinafter referred to in this section as the "WCA") are as follows:"WCA") are as follows:

1. Where a claimant has filed a claim petition 1. Where a claimant has filed a claim petition under the WCA and where his or her claim is under the WCA and where his or her claim is disputed or contested by the employer or its disputed or contested by the employer or its workers' compensation carrier in regard to workers' compensation carrier in regard to whether temporary disability benefits are due to whether temporary disability benefits are due to the claimant in workers' compensation, then such the claimant in workers' compensation, then such claimant may apply for temporary disability claimant may apply for temporary disability benefits under the TDBL and, if eligible, may benefits under the TDBL and, if eligible, may receive temporary disability benefits as allowable receive temporary disability benefits as allowable by law during the pendency of the workers' by law during the pendency of the workers' compensation claim.compensation claim.

2. Where a claimant has not filed a workers' 2. Where a claimant has not filed a workers' compensation claim and seeks benefits through compensation claim and seeks benefits through the TDBL due to an alleged work-related the TDBL due to an alleged work-related condition, the Division of Temporary Disability condition, the Division of Temporary Disability Insurance or private plan disability carrier shall Insurance or private plan disability carrier shall deny said benefits and inform the claimant that deny said benefits and inform the claimant that should he or she file a workers' compensation should he or she file a workers' compensation claim, benefits may be payable pursuant to the claim, benefits may be payable pursuant to the TDBL under (a)1 above.TDBL under (a)1 above.

3. As a condition to receiving temporary disability 3. As a condition to receiving temporary disability benefits under (a)1 above, a claimant shall be benefits under (a)1 above, a claimant shall be required to sign a written subrogation agreement required to sign a written subrogation agreement which documents that the claimant will prosecute which documents that the claimant will prosecute the workers' compensation claim and reimburse the workers' compensation claim and reimburse the Division of Temporary Disability Insurance or the Division of Temporary Disability Insurance or private plan disability carrier, as applicable, from private plan disability carrier, as applicable, from the proceeds of the proceeds of anyany workers' compensation workers' compensation benefits the claimant subsequently receives benefits the claimant subsequently receives based upon thebased upon the same injury or illnesssame injury or illness as that for as that for which the temporary disability benefits were which the temporary disability benefits were obtained under the TDBL.obtained under the TDBL.

4. As a result of the subrogation agreement under 4. As a result of the subrogation agreement under (a)3 above, the Division of Temporary Disability (a)3 above, the Division of Temporary Disability Insurance or private plan disability carrier shall Insurance or private plan disability carrier shall have the right to file a notice of lien with the have the right to file a notice of lien with the Division of Workers' Compensation that shall Division of Workers' Compensation that shall apply against any workers' compensation award apply against any workers' compensation award the claimant subsequently receives that is based the claimant subsequently receives that is based upon the same injury or illness as that for which upon the same injury or illness as that for which the temporary disability benefits were obtained the temporary disability benefits were obtained under the TDBL.under the TDBL.

5. Where the Division of Temporary Disability Insurance or 5. Where the Division of Temporary Disability Insurance or private plan disability carrier has paid benefits to a claimant private plan disability carrier has paid benefits to a claimant under the TDBL and later has reason to believe that the under the TDBL and later has reason to believe that the injury or illness upon which the TDBL benefits were based injury or illness upon which the TDBL benefits were based may also be compensable under the WCA, the Division of may also be compensable under the WCA, the Division of Temporary Disability Insurance or private plan disability Temporary Disability Insurance or private plan disability carrier may file a lien against any workers' compensation carrier may file a lien against any workers' compensation claim.claim.

6. Where a lien has been filed pursuant to (a)4 or 5 above, 6. Where a lien has been filed pursuant to (a)4 or 5 above, or where the parties and/or the Judge of Compensation or where the parties and/or the Judge of Compensation become aware during workers' compensation proceedings become aware during workers' compensation proceedings that benefits had been paid under the TDBL, the Division of that benefits had been paid under the TDBL, the Division of Temporary Disability Insurance or private plan disability Temporary Disability Insurance or private plan disability carrier shall be reimbursed the amount of temporary carrier shall be reimbursed the amount of temporary disability benefits paid pursuant to the TDBL from any disability benefits paid pursuant to the TDBL from any workers' compensation award, order, or settlement workers' compensation award, order, or settlement including lump sum or permanent disability benefits the including lump sum or permanent disability benefits the claimant receives.claimant receives.

7. Where a claimant's workers' compensation award, order, or 7. Where a claimant's workers' compensation award, order, or settlement after deductions for allowances totals less than settlement after deductions for allowances totals less than the amount of the benefits paid under the TDBL, then the the amount of the benefits paid under the TDBL, then the net amount due to the petitioner shall be reimbursed to the net amount due to the petitioner shall be reimbursed to the Division of Temporary Disability Insurance or private plan Division of Temporary Disability Insurance or private plan disability carrier in full satisfaction of the petitioner's disability carrier in full satisfaction of the petitioner's obligation resulting from the written subrogation obligation resulting from the written subrogation agreement.agreement.

8. While a judge of compensation would determine any 8. While a judge of compensation would determine any contested issue with respect to temporary disability contested issue with respect to temporary disability benefits payable by the respondent under the WCA, should benefits payable by the respondent under the WCA, should a claimant wish to contest the amount of the lien or a claimant wish to contest the amount of the lien or reimbursement required under (a)6 above or other issues reimbursement required under (a)6 above or other issues related to the lien or reimbursement, including disabilities related to the lien or reimbursement, including disabilities covered by the lien or reimbursement, the claimant shall covered by the lien or reimbursement, the claimant shall either:either:

i. Reimburse the amount of the temporary disability i. Reimburse the amount of the temporary disability insurance lien as part of the workers' compensation award, insurance lien as part of the workers' compensation award, order or settlement and then appeal, pursuant to (a)9 and order or settlement and then appeal, pursuant to (a)9 and 10 below, such amount or other issues related to the lien 10 below, such amount or other issues related to the lien within 24 days from the date of the workers' compensation within 24 days from the date of the workers' compensation award, order or settlement; oraward, order or settlement; or

ii. File an appeal, pursuant to (a)9 and 10 below, of the ii. File an appeal, pursuant to (a)9 and 10 below, of the reimbursement amount or other issues related to the lien, reimbursement amount or other issues related to the lien, which shall stay the workers' compensation proceedings which shall stay the workers' compensation proceedings until the reimbursement issue is determined.until the reimbursement issue is determined.

Approximately 1,300 temporary Approximately 1,300 temporary disability insurance liens are filed per disability insurance liens are filed per year by the Division of Temporary year by the Division of Temporary Disability Insurance against workers’ Disability Insurance against workers’ compensation awards. During 2005, compensation awards. During 2005, the Division of Temporary Disability the Division of Temporary Disability Insurance recovered liens of Insurance recovered liens of approximately $ 5.65 million through approximately $ 5.65 million through State plan and temporary disability State plan and temporary disability during unemployment.during unemployment.

Methods for resolving or Methods for resolving or “negotiating” TDB liens:“negotiating” TDB liens:

Get application for State Disability Get application for State Disability benefits; review injuries claimed and benefits; review injuries claimed and whether all or part are relevant to the whether all or part are relevant to the workers’ compensation case.workers’ compensation case.

Get treating doctor’s office records.Get treating doctor’s office records. Petitioner may use personal/family Petitioner may use personal/family

doctor; petitioner may have other doctor; petitioner may have other medical conditions that render him medical conditions that render him temporarily, totally disabled.temporarily, totally disabled.

Requirements for TDB differ from Requirements for TDB differ from WCA: for TDB, claimant is unable to WCA: for TDB, claimant is unable to perform the job from which he was perform the job from which he was injured; under WCA, petitioner is injured; under WCA, petitioner is temporarily, totally disabled if unable temporarily, totally disabled if unable to perform any type of work. to perform any type of work.

Q: If there are multiple injuries being Q: If there are multiple injuries being treated and not all from the accident, treated and not all from the accident, then can doctor apportion the overall then can doctor apportion the overall temporary disability?temporary disability?

Get complete set of hospital records; Get complete set of hospital records; compare client’s initial complaints and compare client’s initial complaints and diagnoses with the treating doctors’ notes.diagnoses with the treating doctors’ notes.

Expert physicians narrative report should Expert physicians narrative report should include details of treatment (reasonable include details of treatment (reasonable and necessary treatment) and temporary and necessary treatment) and temporary disability opinion. disability opinion.

Prepare written summary of why TDB lien Prepare written summary of why TDB lien should not be fully or partially reimbursed should not be fully or partially reimbursed from petitioner’s claim; organize all from petitioner’s claim; organize all medical documentation that supports your medical documentation that supports your argument.argument.

Q: Are all potentially, compensible Q: Are all potentially, compensible medical conditions relevant to the medical conditions relevant to the conditions claimed in TDB conditions claimed in TDB application? application?

Q: Are there jurisdictional issues that Q: Are there jurisdictional issues that give rise to potential dismissal (i.e., give rise to potential dismissal (i.e., Section 20)? Section 20)?

Per new code, this is the suggested Per new code, this is the suggested method of resolution.method of resolution.

Request phone conference between Request phone conference between Judge and Temporary Disability Judge and Temporary Disability

Benefits representative (Ed Harding):Benefits representative (Ed Harding):

TDB will review information and TDB will review information and potentially potentially adjustadjust liens in whole or in liens in whole or in part.part.

TDB will notify petitioner of his final TDB will notify petitioner of his final decision; if unfavorable, then he will decision; if unfavorable, then he will inform in writing of right to appeal.inform in writing of right to appeal.

TDB does TDB does notnot negotiate liens. negotiate liens.

If TDB lien is substantial in light of If TDB lien is substantial in light of potential offer of settlement, then potential offer of settlement, then request a hearing on the limited request a hearing on the limited issue of compensability of the lien.issue of compensability of the lien.

Utilize the new administrative rule by Utilize the new administrative rule by either A) filing an administrative either A) filing an administrative appeal and stay the workers’ appeal and stay the workers’ compensation case, or B) file an compensation case, or B) file an administrative appeal with 24 days of administrative appeal with 24 days of the workers’ compensation award, the workers’ compensation award, order or settlement.order or settlement.

Third Party Liens: Section 40Third Party Liens: Section 40

Injured employees or their Injured employees or their dependents are permitted to pursue dependents are permitted to pursue claims against third party tortfeasors claims against third party tortfeasors under the Workers' Compensation under the Workers' Compensation Act. In order to prohibit double Act. In order to prohibit double recovery by the employee, statutory recovery by the employee, statutory provisions have been enacted to provisions have been enacted to permit reimbursement to the permit reimbursement to the employer for recoveries made by the employer for recoveries made by the employee against a third party employee against a third party tortfeasor. tortfeasor. N.J.S.A. 34:15-40N.J.S.A. 34:15-40. .

34:15-40. Liability of third party. 34:15-40. Liability of third party. WhereWhere a a third person is liable to the employee or his third person is liable to the employee or his dependents for an injury or death, the existence dependents for an injury or death, the existence of a right of compensation from the employer or of a right of compensation from the employer or insurance carrier under this statute shall not insurance carrier under this statute shall not operate as a bar to the action of the employee or operate as a bar to the action of the employee or his dependents, nor be regarded as establishing a his dependents, nor be regarded as establishing a measure of damage therein. In the event that the measure of damage therein. In the event that the employee or his dependents shall recover and be employee or his dependents shall recover and be paid from the said third person or his insurance paid from the said third person or his insurance carrier, any sum in release or in judgment on carrier, any sum in release or in judgment on account of his or its liability to the injured account of his or its liability to the injured employee or his dependents, the liability of the employee or his dependents, the liability of the employer under this statute thereupon shall be employer under this statute thereupon shall be only such as is hereinafter in this section only such as is hereinafter in this section provided.provided.

The employer is only responsible for The employer is only responsible for paying its pro rata share of the paying its pro rata share of the counsel fee, and where the counsel counsel fee, and where the counsel fee is less than 33 1/3%, then the fee is less than 33 1/3%, then the employer's responsibility is reduced employer's responsibility is reduced to the percentage of the counsel fee to the percentage of the counsel fee actually assessed on the third party actually assessed on the third party action. action. Pagan v. Hillside Metal Pagan v. Hillside Metal Products, Inc., Products, Inc., 140 N.J.Super. 154, 140 N.J.Super. 154, 355 A.2d 690 (App.Div. 1976).355 A.2d 690 (App.Div. 1976).

The benefits which were paid by an The benefits which were paid by an employer for medical services are subject employer for medical services are subject to reimbursement and are included in the to reimbursement and are included in the determination of the employer's lien. determination of the employer's lien.

In In Raso v. Ross Steel Erectors, IncRaso v. Ross Steel Erectors, Inc., 319 ., 319 N.J.Super. 373, 725 A.2d 690 N.J.Super. 373, 725 A.2d 690 (App.Div.1999), the respondent was (App.Div.1999), the respondent was entitled to assert a lien for the services entitled to assert a lien for the services provided by a rehabilitation nurse as the provided by a rehabilitation nurse as the expenses could be demonstrated to expenses could be demonstrated to provide care that was necessary to cure provide care that was necessary to cure and relieve the employee from the effects and relieve the employee from the effects of the injury. The Court permitted of the injury. The Court permitted apportionment of the expenses if not all apportionment of the expenses if not all can be deemed to meet that criteria. can be deemed to meet that criteria.

The employer's negligence plays no The employer's negligence plays no part in the operation of N.J.S.A. part in the operation of N.J.S.A. 34:15-40; there is no joint liability of 34:15-40; there is no joint liability of the employer and the third-party the employer and the third-party tortfeasor to the injured employee. tortfeasor to the injured employee. Even if the employer's negligence Even if the employer's negligence contributed to the employee's injury, contributed to the employee's injury, the employer's right to reimburse-the employer's right to reimburse-ment is not extinguished.ment is not extinguished. Schweizer Schweizer v. Elox Division of Colt Industriesv. Elox Division of Colt Industries, 70 , 70 N.J. 280, 359 A.2d 857 (1976).N.J. 280, 359 A.2d 857 (1976).

The employer is limited to those injuries for which The employer is limited to those injuries for which a third party claim was actually asserted, and a third party claim was actually asserted, and third party recovery obtained by an employee third party recovery obtained by an employee during his lifetime is not considered to be a during his lifetime is not considered to be a recovery in favor of his dependents following his recovery in favor of his dependents following his death, against which an employer can impose a death, against which an employer can impose a lien. The surviving spouse of a firefighter, lien. The surviving spouse of a firefighter, individually and as administratrix of the estate of individually and as administratrix of the estate of a firefighter brought a civil action against the a firefighter brought a civil action against the public entity, the fire department, fire director, public entity, the fire department, fire director, fire chief and electric utility alleging multiple fire chief and electric utility alleging multiple causes of action including survival and wrongful causes of action including survival and wrongful death. The Court held that the workers' death. The Court held that the workers' compensation lien attaches to any amount compensation lien attaches to any amount recovered in a wrongful death action, but that it recovered in a wrongful death action, but that it does not attach to the proceeds of a survival does not attach to the proceeds of a survival claim for pain and suffering, when the injured claim for pain and suffering, when the injured employee had not filed a claim petition nor employee had not filed a claim petition nor received any workers' compensation benefits. received any workers' compensation benefits. DeLane ex rel. DeLane v. City of NewarkDeLane ex rel. DeLane v. City of Newark, 343 , 343 N.J.Super. 225, 778 A.2d 511 (App.Div.2001).N.J.Super. 225, 778 A.2d 511 (App.Div.2001).

Funeral expenses are not considered to be Funeral expenses are not considered to be payments of compensation and are not payments of compensation and are not includable in a lien against third party includable in a lien against third party recovery asserted by an employer. recovery asserted by an employer. O'Brien v. New Jersey State Highway O'Brien v. New Jersey State Highway DeptDept., 11 N.J.Super. 548, 78 A.2d 717 ., 11 N.J.Super. 548, 78 A.2d 717 (App.Div.1951).(App.Div.1951).

Damages awarded or allocated under the Damages awarded or allocated under the “per quod claim” are not subject to a lien. “per quod claim” are not subject to a lien. Weir v. Market Transition Facility of New Weir v. Market Transition Facility of New Jersey, et alJersey, et al., 318 N.J.Super. 436, 723 A.2d ., 318 N.J.Super. 436, 723 A.2d 1231 (App.Div.1999).1231 (App.Div.1999).

Payments made pursuant to N.J.S.A. 34:15-20 are Payments made pursuant to N.J.S.A. 34:15-20 are not considered payments of compensation and not considered payments of compensation and are not subject to reimbursement should there be are not subject to reimbursement should there be third party recovery. The lump-sum payment by third party recovery. The lump-sum payment by the carrier in settlement with the common-law the carrier in settlement with the common-law wife of the deceased was exempt from the wife of the deceased was exempt from the carrier's general lien for reimbursement out of the carrier's general lien for reimbursement out of the proceeds paid by the third party. The court stated proceeds paid by the third party. The court stated that the lump-sum settlement of the controversy that the lump-sum settlement of the controversy between the employer and the employee or between the employer and the employee or dependents of the employee was recognized as dependents of the employee was recognized as payment of workers' compensation benefits for payment of workers' compensation benefits for insurance rating purposes only. Such settlement insurance rating purposes only. Such settlement had the force and effect of a dismissal of the had the force and effect of a dismissal of the claim petition, was final and conclusive upon the claim petition, was final and conclusive upon the petitioner, and was a complete surrender of any petitioner, and was a complete surrender of any right to compensation or other benefits arising right to compensation or other benefits arising out of the claim. out of the claim. Aetna Life and Casualty v. Estate Aetna Life and Casualty v. Estate of Engardof Engard, 218 N.J.Super. 239, 527 A.2d 497 (Law , 218 N.J.Super. 239, 527 A.2d 497 (Law Div.1986).Div.1986).

Respondent is not entitled to lien reimbursement Respondent is not entitled to lien reimbursement when the third party tortfeasor's insurance carrier when the third party tortfeasor's insurance carrier has become insolvent and the New Jersey has become insolvent and the New Jersey Property Liability Insurance Guaranty Association Property Liability Insurance Guaranty Association has undertaken the defense and indemnification has undertaken the defense and indemnification of the tortfeasor. The court confirmed that of the tortfeasor. The court confirmed that injured workers are not entitled to double injured workers are not entitled to double recovery for the same injury and that the recovery for the same injury and that the Guaranty Association is obliged to pay only the Guaranty Association is obliged to pay only the difference between workers' compensation difference between workers' compensation benefits and the employee's recovery against the benefits and the employee's recovery against the tortfeasor if the latter is greater than the former. tortfeasor if the latter is greater than the former. In any event, the workers' compensation insurer In any event, the workers' compensation insurer is limited in asserting its reimbursement lien to a is limited in asserting its reimbursement lien to a claim against the insolvent insurer's receiver and claim against the insolvent insurer's receiver and may not assert a lien against the Guaranty may not assert a lien against the Guaranty Association. Association. Sussman v. OstroffSussman v. Ostroff, 232 N.J.Super. , 232 N.J.Super. 306, 556 A.2d 1301 (App.Div.1989), certif. denied 306, 556 A.2d 1301 (App.Div.1989), certif. denied 117 N.J. 143, 564 A.2d 865 (1989). 117 N.J. 143, 564 A.2d 865 (1989).

Dealing with section 40 liens:Dealing with section 40 liens:

Discuss with petitioner during initial Discuss with petitioner during initial consultation.consultation.

Client may think he can have a Client may think he can have a “double recovery” of money.“double recovery” of money.

Remind client that you (or both his Remind client that you (or both his attorneys) will try to recover money attorneys) will try to recover money in both claims that when considered in both claims that when considered as a whole, fully and fairly as a whole, fully and fairly compensates client.compensates client.

Periodically request that W/C Periodically request that W/C carrier’s subrogation department carrier’s subrogation department provide complete lien statement:provide complete lien statement:

Lien should be itemized, including Lien should be itemized, including medical, temporary, and permanent medical, temporary, and permanent disability benefits paid.disability benefits paid.

Review all amount included in Review all amount included in payment of medical benefitspayment of medical benefits

Maintain communication with W/C Maintain communication with W/C carrier throughout third party claim.carrier throughout third party claim.

Inform carrier of any difficult issues Inform carrier of any difficult issues in third party case (i.e., Title 59, in third party case (i.e., Title 59, Verbal Threshold, Liability issues)Verbal Threshold, Liability issues)

Provide carrier with written summary Provide carrier with written summary outlining third party case and issues; outlining third party case and issues; provide supporting documentation provide supporting documentation (deposition transcripts, relevant case (deposition transcripts, relevant case law or statutes)law or statutes)

Be careful when resolving third party Be careful when resolving third party case when client is still getting case when client is still getting medical treatment benefits from medical treatment benefits from compensation carrier.compensation carrier.

Negotiate compromise of lien so that Negotiate compromise of lien so that client can continue to receive client can continue to receive treatment payable 100%.treatment payable 100%.

Q: Confirm compromise agreement Q: Confirm compromise agreement in writing! Does compromise of in writing! Does compromise of outstanding lien end future lien outstanding lien end future lien assertions if future compensation assertions if future compensation benefits provided?benefits provided?

Q: If med/temp compensation Q: If med/temp compensation benefits paid but case ends via benefits paid but case ends via Section 20, does subsequent third Section 20, does subsequent third party settlement require party settlement require reimbursement of those comp reimbursement of those comp benefits paid?benefits paid?

Randy Grossman, Esq.Randy Grossman, Esq.

Greenberg, Walden & Grossman, L.L.C.Greenberg, Walden & Grossman, L.L.C.425 59th Street425 59th Street

West New York, NJ 07093West New York, NJ 07093201-854-2200201-854-2200

201-854-4293 fax201-854-4293 fax

randy@greenberg-walden.comrandy@greenberg-walden.com www.greenberg-walden.comwww.greenberg-walden.com