Anesthesia Associates of Morristown v. Weinstein Supply Co. and Surgicare of Jersey City v. Waldbaums, Docket No. A-5033-18T4 and A-5718-18T4 (App. Div., Decided Oct. 7, 2020)

Absent a sufficient basis for the Division of Workers’ Compensation to assert jurisdiction over an underlying workers’ compensation claim, Division cannot assert jurisdiction over an extraterritorial medical provider application derived from that claim.

In these two appeals that were consolidated for the purposes of writing a single opinion, the Appellate Division determined that a New Jersey medical provider cannot file an independent claim under the New Jersey Workers’ Compensation Act, N.J.S.A. 34:15-1 et seq., to recover payment  for medical services from their patients’ employers where the patients lived and work outside of New Jersey, were injured outside of New Jersey and filed workers’ compensation claims in their home states.  

Anesthesia Associates of Morristown and Surgicare of Jersey City both appealed from orders issued by two Judges of Compensation dismissing their medical provider claims for lack of jurisdiction. In the Anesthesia Associates’ matter, the employee suffered compensable work-related injuries in an accident in 1998. The accident took place in Pennsylvania, the injured worker was a Pennsylvania resident and the employer, Weinstein Supply Corporation, was based in Pennsylvania. The injured worker also filed a workers’ compensation claim with the Pennsylvania Bureau of Worker’s Compensation.

On March 22, 2018, Anesthesia Associates rendered services to the injured worker at a New Jersey hospital. It then submitted a claim to the Pennsylvania Department of Labor and Industry and received payment per that Department’s fee schedule. Anesthesia Associates then initiated a medical provider application with the New Jersey Division of Workers’ Compensation, even though there was no pending workers’ compensation claim filed in New Jersey by the employee. The medical provider’s application stated that Anesthesia Associates alleged that “the Employee sustained an injury by an accident arising out of an in the course of her employment with Respondent [that was] compensable under [the Act].”

Weinstein Supply Corporation file a motion to dismiss for lack of jurisdiction, which Anesthesia Associates opposed. In support of its motion, Weinstein filed a certification from its counsel setting forth facts that demonstrated there was no connection between New Jersey and either the injured employee, who had filed a claim in Pennsylvania, or his employer. Anesthesia Associates filed an opposition to Weinstein’s motion, arguing that the New Jersey Division had jurisdiction over the claim as Pennsylvania’s Act vested the New Jersey Division with “exclusive jurisdiction for any disputed medical charge, and because New Jersey had a substantial interest in the subject matter – i.e., the payment of New Jersey medical provider bills.”

On June 19, 2019, the Judge of Compensation granted Weinstein’s motion and dismissed Anesthesia Associates’ claim for lack of jurisdiction. In her written decision, the judge reasoned:

[I]t should go without saying that when the Legislature amended [the Act] to give the workers’ compensation court exclusive jurisdiction for any disputed charges arising from any claim for a work-related injury or illness[,] that the claim had to be one compensable under New Jersey law. As our courts have held that a petitioner’s New Jersey residence alone is an insufficient basis for jurisdiction, clearly one day of treatment in New Jersey is insufficient to grant New Jersey jurisdiction over this claim.

With regards to Surgicare’s matter, the facts were similar. The injured employee, a resident of New York who had been hired in New York by his employer, Waldbaums, suffered a compensable injury as a result of a work-related accident in Brooklyn, New York, on February 20, 2010. The injured worker filed a workers’ compensation claim in New York. On January 5, 2017, the employee’s New York physician filed with the Workers’ Compensation Board of New York (WCBNY) a request for authorization for the employee to undergo surgery, listing the injured worker’s employer as Waldbaums in Brooklyn, New York. The WCBNY determined that surgery was necessary and that Waldbaums was liable for payment of these services in accord with New York law. The employee underwent surgery at Surgicare’s facility in New Jersey, and Surgicare received payment in accord with the WCBNY fee schedule.

On July 17, 2018, Surgicare filed a medical provider application with the New Jersey Division of Workers’ Compensation. The medical provider’s application stated that Surgicare alleged that “the Employee sustained an injury by an accident arising out of and in the course of her employment with Respondent [that was] compensable under [the Act].” On August 2, 2018, Waldbaums filed a motion to dismiss for lack of jurisdiction. In support of its motion, it filed a certification from its counsel attesting to facts that established New Jersey had no relation to the employee’s injury or claim. Surgicare filed an opposition to the motion to dismiss, arguing that as Waldbaums did business in New Jersey and as the employee was treated in New Jersey, the claim should not be dismissed.

On July 18, 2019, the Judge of Compensation dismissed Surgicare’s medical provider application with prejudice for lack of jurisdiction. The judge stated that Surgicare:

…provided medical treatment to a patient who lived in New York, who worked in New York for a New York Employer, who was injured in New York and who received medical treatment in New York, [and who] was directed by his New York doctor to a surgical center in New Jersey for a single, one-day visit. The patient’s same-day surgery was performed by a New York doctor using equipment and devices ordered by the New York doctor. [Surgicare] filed an [medical provider application] in New Jersey’s workers’ compensation court seeking payment above and beyond that authorized by the workers’ compensation law of the State of New York.

The Judge of Compensation concluded that one day of treatment in New Jersey “did not rise to the standard of sufficient purposeful minimal contacts requisite to vest this court with personal jurisdiction.”

In affirming the dismissals with prejudice of Anesthesia Associates’ and Surgicare’s claims, the New Jersey Appellate Division acknowledged that the Division does have exclusive jurisdiction for any disputed medical charges arising from any claim for compensation for a work-related injury or illness. However, ascribing to the statute’s plain language, its ordinary meaning and significance, the Appellate Division reasoned that:

[C]ontrary to Anesthesia Associates’ and Surgicare’s arguments, by limiting its application to “claims for compensation,” the statute did not apply to [medical provider applications] in matters where the Division did not have jurisdiction over an employee’s related claim under the Act. That limitation was recognized by both Anesthesia Associates and Surgicare when they executed their medical provider applications that alleged the employees’ claims were “compensable under the Act.”

As such, the New Jersey Appellate Division concluded that, unless the Division has jurisdiction over the underlying claim for a compensable work-related injury, it does not have jurisdiction over an medical provider’s application for payment.

This decision establishes that a medical provider’s application is derivative of an injured worker’s claim, and it demonstrates the importance of careful examination of any extraterritorial medical provider’s application. Under New Jersey law, in order to make a determination as to jurisdiction, a court must consider the following six basis: [1] the place where the injury occurred; [2] the place of making the employment contract; [3] the place where the employer relation exists or is carried out; [4] the place where the industry is localized; [5] the place where the employee resides; and [6] the place whose statute the parties expressly adopted by contract. Absent sufficient basis for the Division to assert jurisdiction over an injured worker’s underlying claim, the Division cannot assert jurisdiction over a medical provider’s application derived from that claim.

 

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