The NJ Workers’ Compensation Act | Callagy Law

Examining the Exclusive Remedy Provision of New Jersey’s Workers’ Compensation Act

The following article was written by Callagy Law’s Legal Team, and will focus on many common questions and concerns surrounding new developments, legal matters, and other procedures within the field of healthcare law Medical Revenue Recovery, PIP, Workers Compensation, and Commercial Insurance. Our mission is to answer any questions and give knowledge to many different aspects of these matters.

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In view of N.J.S.A. 34:15-8, it has been understood that the Division of Workers’ Compensation (“the Division”) is vested with exclusive jurisdiction over claims arising out of employment related injuries. In relevant part, N.J.S.A. 34:15-8 states:

34:15-8. Election surrender of other remedies. Such agreement shall be a surrender by the parties thereto of their rights to any other method, form or amount of compensation or determination thereof than as provided in this article and an acceptance of all the provisions of this article, and shall bind the employee and for compensation for the employee’s death shall bind the employee’s personal representatives, surviving spouse and next of kin, as well as the employer, and those conducting the employer’s business during bankruptcy or insolvency.

If an injury or death is compensable under this article, a person shall not be liable to anyone at common law or otherwise on account of such injury or death for any act or omission occurring while such person was in the same employ as the person injured or killed, except for intentional wrong.

In a recent case, the New Jersey Supreme Court found that the Superior Court had jurisdiction to make a threshold determination as to whether an injured worker was an employee or an independent contractor. See: Estate of Kotsovska v. Liebman, 221 N.J. 568 (2015). The Liebman case involved a wrongful death action brought by the estate of the deceased worker. At issue was whether the decedent was an employee or independent contractor. Significantly, the estate had not filed a petition with the Division. The Court held that when “there is a genuine dispute regarding the worker’s employment status, and the plaintiff elects to file a complaint only in the Law Division of the Superior Court, the Superior Court has concurrent jurisdiction to resolve the dispute.” In its analysis, the Court emphasized that “there was no claim pending before the Division over which it could assert jurisdiction.” The Court further reasoned that the doctrine of primary jurisdiction was inapplicable on the grounds that the question of a worker’s employment status is often determined by trial judges and juries, the Division is in no better position than the Superior Court to determine a worker’s employment status, and there was no risk of inconsistent rulings because a petition had not been filed with the Division.

It is expected that this decision will result in increased filings of workplace injury lawsuits in the Superior Court where the worker is claiming to be an independent contractor to avoid some of the limitations on redress in the Division.

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We hope you have found this information helpful and interesting. Please reach out to us here with any questions or comments regarding healthcare legal matters, or if you are a medical provider that has questions regarding Medical Revenue Recovery, PIP, Workers Compensation, and Commercial Insurance.. Feel free to search us on Facebook, Twitter or LinkedIn! Additionally you can subscribe to our daily videos on YouTube.

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New AND FREE to Share - Why Not with Sean Callagy #16

Today’s Why Not Huddle with Sean Callagy:

Why Not Realize Defensiveness Destroys! 

Dear Kindred Spirits, Welcome to our third “Why Not” Friday, and your 16th episode of the Why Not Huddle.

How are you doing so far?

We are here to support you. Send any questions or comments to scallagy@callagylaw.com if you need a private response or post your questions for a response.

Yesterday, we were discussing a very common challenge for all of us: when it’s us, we don’t think we can “do” much more to change things to increase the quality of our results.

When last we spoke, our friend from yesterday was believing she was doing “everything”. I have heard this more times than you can imagine over the past twenty years. One of the great destroyers of success is people’s defensiveness.

Most often, their defensiveness is rooted in a feeling that somehow their success, whether it be financial, sales, business, career, or whatever, is directly connected to who they are and their value as a human being.

We had a great comment from Paul C. yesterday describing the amazing compounding of a penny over one month. Check it out on Callagy Law Facebook. It is this concept that most people cannot grasp, in my experience, when it comes to them.

When I speak with business people who have big goals, but are challenged to reach them, they want to hear new “tricks”. What people become defensive and resistant when we begin to discuss the very simple shifts available that can create enormous benefits. In the situation with my friend, a real life example, she felt very successful in negotiating a $15,000.00 per month billing contract. I thought she got completely taken advantage of and her fear got to her.

She didn’t like hearing that. I am completely confident that a fair arrangement would have yielded one to two million dollars per year. She really didn’t like hearing that. Moreover, I shared that she didn’t have enough products to cover her clients’ full needs, and therefore, was losing sales. I also believed her marketing process to get to meetings was very weak, and therefore, tons of opportunities were being missed. Her response was that I thought I was smarter than her, and did I know how much she’s accomplished.

My answer: I don’t care. Well, I do care, but not enough for me to lie to her and tell her something different than the truth. The truth is, a few tiny changes, and the company will go from a one million dollar to ten million dollar company in less than three years. She still didn’t like it.  Why? She was at affect.

She was also lacking the at cause ability to be completely self-aware and open to the turning of a couple of small screws to explode her business forward. After a few tears and some back and forth (that’s where my skills come in), we agreed to turn those screws. Here’s the challenge though: we all do this.

We all avoid the simple obstacles that will lead us to our results because we are often very emotionally committed to its meaning about us a smart, strong and competent person.

What? It goes like this: could a twenty dollar book or a free video really increase my income by thousands or even millions of dollars over time. Absolutely!!!!!!!!!! BUY, not if defensiveness and the need to prove how unique and impossibly unique your problems are. Let’s be open, self-aware and AT CAUSE! Have an amazing Friday and weekend.

Please share this, ask questions and post comments. We are over 11,000 Callagy Law Facebook Likes. Next stop: 50,000. Please help us get there. When we do, we are giving away a phenomenal gift worth over $1,000.00 to everyone.

Why Not?

In Your Service,

Sean Callagy

Please subscribe on YouTube and spread the word.

You can see all of our WHY NOT – HUDDLE videos by clicking here and subscribing! If you have questions about any of the content you see or to have your questions answered on an upcoming show by Sean, please email your questions directly to him by clicking here.

The Daily Why Not Huddle is for you if you want more money, time, or fulfillment. The Why Not Huddle with business coaching expert, successful entrepreneur, and attorney Sean Callagy provide the essential daily ingredients for you to create and achieve your destiny.

New AND FREE to Share - Why Not with Sean Callagy #16 #CallagyCoaching, #CallagyLaw, #LawOfficeOfSeanRCallagy, #LegalFacts, #Motivation, #NewJersey, #SeanCallagy, #SeanRCallagy, #Success, #WhyNot

NEW! Free! Why Not #13 - Why Not Double Your Income? - November 10, 2015

Today’s Why Not Huddle with Sean Callagy

Dear Kindred Spirits:

 

Before we get to this question, please check out our Why Not Talk with sales award winner Rey Rostami who’s used my Success Formula to triple meeting numbers for his team. There’s a challenge though… We are going to help Rey out! Join us on YouTube and subscribe. Hey, it’s got massive value, and it’s FREE. Anyone you know that is involved in sales has will benefit big time.

 

Now, suspend your belief for a moment, and simply answer this question: Would You Want to Double Your Income?

 

How does that question make you feel?

 

Does it make you excited? Does it make you stressed? Does it make you think I’m setting you up for something? Does it make you feel like there’s a scam on the way?

 

They idea of Why Not is to be the first indispensable building block of living “At Cause” (for a great explanation on that, check out Why Not Episode number 11 from November 6, 2015).

 

When we begin to discuss the idea and topic of money, it impacts people in ways that are directly related to our feelings about money. Our feelings about money relate to our beliefs about money.

 

What do you think about people who are RICH?

 

Describe how rich people act, feel, and relate to other people. What level of empathy and caring do “rich” people display?

 

I don’t mean tell me what you think is the “right” answer. I mean tell me what you really feel.

 

If your answer is positive, then I guarantee you that you either have or are on your way to having, more money than most people.

 

On the other hand, if you are answering that question in a negative way, then I would say that money and finances are a challenge in your life.

 

Now, before you feel judged, please keep in mind that I am trying to help. We will talk more about money in the future. This short letter is designed to help you think about the basics of where you are emotionally, right now, with regard to your relationship to money.

 

By the way, most, certainly mot all, but most people would like to double their income. What is amazing, is how relatively easy it is to do.

 

Now, I’ve possibly really touched a nerve. Money is one of the issues most attached to our egos. Thus, there may be a strong desire to make me “wrong” right now that you are feeling.

 

You’ve possibly heard me introduce the concept of “Zone Action” in prior Why Not Huddles. After having spent time coaching hundreds of different people, I’ve found that very few people ever get near Zone Action to increase their income or the profit from their business.

 

I am fortunate to earn a great living. Within one year, if I so choose and follow my own success formula, I would certainly double my income. I know this with absolute certainty. The only way I wouldn’t, is if I wasn’t in Zone Action.

 

The challenge is, most people never get into Zone Action to double their income because they don’t have the right emotional relationship with money.

 

So, for today, think about what you really feel. Then, ask if those feelings are serving you and your finances.

 

On a final note: don’t think you can set the value for double your salary. That is a major move. It is set by the value you create for others, either your company or your clients if you own a business.

 

Then, be ready to truly live a Why Not life and commit to playing a huge game to get there.

 

By the way, I helped one client go from making $150,000.00 per year to $500,000.00 per year in 1, yes ONE, coaching session. That income level lasted for nearly a decade from one of his businesses.

 

And no, I am not actively taking on coaching clients right now. I’m telling you that to help you to understand that I know what I am talking about and how real your potential is.

 

Why Not?

 

If you see value in these Why Not Letters and our Why Not Talks, please forward them and share them. Subscribe to our Why Not Huddle on my Sean Callagy You Tube and like our Callagy Law Facebook Page to get these materials.

 

Check out our Why Not Talk with Rey Rostami later today who increased meeting numbers by numbers incredibly by application of my Success Formula.

 

In Your Service,

 

Sean Callagy

Please subscribe on YouTube and spread the word.

You can see all of our WHY NOT – HUDDLE videos by clicking here and subscribing! If you have questions about any of the content you see or to have your questions answered on an upcoming show by Sean, please email your questions directly to him by clicking here.

The Daily Why Not Huddle is for you if you want more money, time, or fulfillment. The Why Not Huddle with business coaching expert, successful entrepreneur, and attorney Sean Callagy provide the essential daily ingredients for you to create and achieve your destiny.

NEW! Free! Why Not #13 - Why Not Double Your Income? - November 10, 2015 #CallagyCoaching, #CallagyLaw, #Motivation, #NewJersey, #NjLawFirm, #SeanCallagy, #SeanRCallagy, #Success, #Youtube

Contesting a Will in New Jersey

WHO:

Only certain people can contest a Will in the State of New Jersey. To do so, you Will have to be one of those certain people or groups who have what is called “standing”. Generally speaking, standing or locus standi means you must be a party who has a direct interest in the action and can show you Will sustain a direct injury or harm related to the action.  So who has standing to contest a Will in New Jersey?

The first class of people or groups who may have standing to contest a Will include those who would have had an interest in the estate if there was no Will, otherwise known as an heir at law. For example, a child who would be entitled to a share of the deceased if there was no Will, would have standing to contest a Will if the Will that exists does not include the child. This is not to say that such a ‘disinherited child’ is automatically entitled to a share of the estate, but simply that they are in the group of people who would otherwise have standing to contest a Will.

Furthermore, anyone named in a prior Will would also have standing to challenge a Will if the Will entered into probate eliminates or even reduces the share afforded to that person or group in prior Will. Again, this is not to suggest that one named in a prior Will would be successful, but being named in a prior Will does confer standing to challenge a Will.

It is not just a “person” who might have standing to challenge a Will but even groups or corporations who can challenge a Will. So if a later Will reduces a charitable donation left in earlier Will, the charity will be deemed to have standing to contest a Will.

WHAT:

Under New Jersey law, there are essentially two basis upon which the validity of a Will can be contested. The first basis is to allege that the decedent lacked the Testamentary Capacity to have executed the Will that is being presented for probate. In other words, the Testator was not of sound mind when they executed the Will. This is often a difficult and very expensive allegation to prove as the Testamentary Capacity to execute a Will does not legally require much to prove but conversely, requires a substantial amount of medical evidence to disprove.

 

The second basis to contest the validity of a Will is premised on an allegation of Undue Influence on the Testator during the crafting of the Will by another who has a confidential relationship with the Testator. Here, the challenger will have to prove that the Testator was so unduly influenced by another person to the point that the Will ultimately reflected the wishes not of the Testator, but rather, the wishes of the Influencer. This basis will also require a showing that the Testator had a confidential relationship with the person.

 

WHERE:

In the State of New Jersey, the Surrogate’s Office is the office responsible for the administration of an estate, including admitting a will to probate and granting letters of administration to an appropriate person to carry out the duties of the decedent. Typically, Wills are entered into probate by the Surrogate’s Office in the County in the decedent lived. This is not always the case however, as a Will can also be filed in the County where the decedent owned property.

Will contests, usually filed as a Caveat to the Will, will halt the probate of a Will and will generally also start by being filed in the Surrogates Court of the County where the Will was filed for probate. Once the Caveat is filed, the contest to the Will be moved to Superior Court.

WHEN:

The first step in a Will contest is to block the Will from being probated. In New Jersey, Wills cannot be entered into probate until 10 days after the death of the decedent. This window of time guarantees anyone with standing at least ten days to file a Will contest before the Will is probated.

In the event, a caveat is not blocked in time at the Surrogates office, or in the correct County, New Jersey still affords a four month window to New Jersey residents and a six month window to out of state residents, after the Will has been entered into probate to go directly to the Superior Court to file to a motion to contest a Will.

HOW:

As stated above, if you believe you are a person who has standing and you wish to contest a Will, you should go directly to the Surrogates Office in the County or Counties in which you think the Will be filed for probate and file a Caveat as soon as the possible after the death of the Testator.

A Caveat is simply a document that when filed prevents the Will from being entered into Probate.  This will start the process.

Once the Caveat is filed, the matter then be moved from the Surrogates Court to Superior Court where the challenge to the validity of the Will be heard.

The Caveat must be filed in the County where the Will is going to be probated, however, if you wish to contest a Will, you can file the Caveat in as many Counties as necessary to make sure you are filed in the County where the Will be filed for probate.

Contesting a Will in New Jersey #Attorney, #Callagylaw, #Information, #Lawyer, #NewJersey, #Will

Callagy Law: Commercial Insurance Law firm Recovery for Out-of-Network Healthcare Providers

You’ve got to fight for your right to recovery

Let’s face it – most doctors have a stack of files they’ve just given up on.  These files contain thousands, perhaps, millions of dollars, that remain completely unpaid by insurance companies, with little to no explanation as to why.

Out-of-network doctors face a peculiar dilemma.  They’ve made a business decision to not engage in contracts with insurance companies, whether it be that they thought the contracts were too restrictive or perhaps they were not getting enough referrals to make the bargain favorable for them.  Whatever the case may be, in a free market, doctors have the choice to charge what they want for the specialized services they provide.  However, this does not mean that insurance companies have the right to unfairly deny proper reimbursement with no explanation. Healthcare providers need the experience of a Commercial Law firm to help them recover what is owed to them.

What is Major Medical/Commercial Insurance?   

“Major Medical Insurance” or what Callagy Law, along with Sean Callagy now refers to as Commercial Insurance or CI, is your primary healthcare insurance.  Callagy Law’s CI department handles these types of cases.

The Rights of Out-of-Network Healthcare Providers under ERISA (Employee Retirement Income Security Act)

ERISA is a federal law that sets minimum standards for health benefit plans in private industry, should an employer choose to set one up for its employees.  ERISA requires health benefit plans to regularly provide participants with information about the plan.  ERISA also gives participants or beneficiaries the right to sue for benefits and breaches of fiduciary duty. 

What Callagy Law is doing with ERISA that no other law firm does!

Callagy Law is doing what no other law firm does – Major Medical or Commercial Insurance is an area of law that few, if any, law firms venture to take on.  There are hardly any that pursue these claims on the level of Callagy Law and Sean Callagy.  Callagy Law has approximately 50 active clients on whose behalf we aggressively fight for in both Superior and Federal Court.  However, prior to filing any suit, Callagy Law works with doctor’s offices to ensure they are using the Assignment of Benefits and appeals required in order to properly pursue these ERISA claims.  

Callagy Law is a full service Commercial Insurance law firm! There have been several significant amendments to ERISA concerning health benefit plans which help out of network providers recover.  Callagy Law has the specific knowledge and fierce determination to pursue these claims and recover money from the files that are just sitting there! As a Commercial Insurance law firm it our job and pleasure to recover this money for healthcare providers.

Contact our office today for a complimentary evaluation or consultation concerning your Commercial Insurance needs by calling 201.261.1700 or email us at inquiries@callagylaw.com. 

A day in the life of a PIP Attorneys in New Jersey working for Sean Callagy at Callagy Law

I work as one of the PIP Attorneys in New Jersey for Sean Callagy at Callagy Law.  I love my job.  A day in my life boils down to being a crime fighter.  I catch big insurance companies lying, cheating and stealing, and I help bring them to justice.

Who am I protecting? 

Your friendly neighborhood doctors!  At Callagy Law, we have hundreds of clients, from the biggest hospitals in the state, to local “mom and pop” single doctor practices.  And every day, Sean Callagy, the New Jersey PIP Attorneys at Callagy Law, and I battle the biggest Villains in the insurance world. These Villains lie, cheat, and steal from our doctors and deny necessary medical treatment to their patients. Of course not all insurance companies are like this, however, rest assured that there are some.

How do the Villains lie, cheat and steal?

The biggest way that these Villains cheat providers out of their money is through sophisticated automated computer systems.  The bills submitted by our providers are run through automated billing computers which make hundreds, if not thousands, of mistakes every day.  When our clients appeal, trying to correct the mistakes, and recover the money they’re rightly entitled to, another computer system automatically denies them. The Villains also send patients to their own private villainous evil doctors (I’ll call them Dr. Evil for short) who deny any further medical treatment to the patients.  Dr. Evil thinks he can look at a patient for about 20 minutes, and then say that the patient has fully recovered from a car accident, even if the patient is still in 10 out of 10, excruciating agony.

Why do they do it?

Money!  Why else? 

Every day, the Villains are laughing all the way to the bank.  The bank where, by the way, they have hundreds of millions of dollars sitting in accounts earning interest.  The Villains earn SO MUCH MONEY just off the interest in these accounts, which they can afford to pay for all the arbitrations that we, the New Jersey PIP Attorneys working for Sean Callagy at Callagy Law can possibly file.

Why do we do it?

Because we know it matters.  Our clients are deeply affected by the lying, cheating and stealing done by these Villains, and Sean Callagy, the PIP Attorneys in New Jersey at Callagy Law, and I do battle for our clients every day, because when the Villains eventually put all of these doctors out of business with their lying, cheating, and stealing, who will be left to care for us?

Again not all insurance companies, and certainly not all the people who work for these companies, are as bad as others. And certainly there are doctors across the country who are deceptive and do wrong. That is why it is important to have a knowledgeable and integrity filled law firm on your side.

For more information about PIP, PIP attorneys and Callagy Law please contact us at inquiries@callagylaw.com, or call 201.261.1700.