Commonwealth Court of New Jersey - Case Summaries
Maccarone v. State of New Jersey
(App. Div. # A-5028-09T1; Decided June 23, 2011)
State employee’s exclusive remedy when injured in a motor vehicle accident involving a uninsured phantom vehicle is only workers’ compensation, and no UM claim can be sought against the State
Background
Plaintiff Samuel Maccarone, a corrections officer employed by the Department of Corrections, was participating in the transport of an inmate in a State-owned vehicle when a phantom vehicle caused the State vehicle to leave the roadway and crash. Plaintiff was seriously injured and filed a claim for workers’ compensation benefits which was accepted. Plaintiff also sought to obtain additional relief from the State by filing an uninsured motorist (UM) claim for his injuries. Plaintiff argued that the State was subject to the requirement in N.J.S.A. 39:6A-14 to maintain compulsory UM coverage and therefore, had to provide him with a minimum of $250,000 in UM benefits. The State denied the claim, noting that they were exempt from the provisions of the Motor Vehicle Security-Responsibility Law (Responsibility Law), N.J.S.A. 39:6-23-60 and therefore, did not carry uninsured motorist, underinsured motorist, or personal injury protection (PIP) coverage. In seeking UM coverage from the State, Plaintiff argued that his claim was not subject to either the workers' compensation exclusive remedy bar, or to the requirements of the Tort Claims Act, N.J.S.A. 59:1-1 to 12-3. Rather, Plaintiff contended that the 1987 amendment to the Responsibility Law effectively removed the State's exemption from the compulsory UM and other motor vehicle insurance mandates of N.J.S.A. 39:6A and N.J.S.A. 39:6B.
Holding
The Appellate Division disagreed with Plaintiff and concluded that workers' compensation was the exclusive remedy available to Plaintiff. The Court determined that the statute provided an exemption for public entity-owned vehicles from New Jersey's No-Fault insurance scheme and from the Compulsory Insurance Law. In support of its conclusion, the court noted that its determination was consistent with both the Legislature's decision to limit public entity liability pursuant to the Tort Claims Act, and with the court’s prior ruling that a public entity which has not chosen to procure insurance or provide self-insurance is exempt from providing UM coverage.
Any questions regarding this case can be directed to Oliver M. Bather at 610-332-7006 or (obather@tthlaw.com).
Maccarone v. State of New Jersey
(App. Div. # A-2393-10T3; Decided June 27, 2011)
Prolonged inactivity while working at home, if greater than one’s non-work inactivity, which ultimately causes a pulmonary embolism, is a compensable cardiovascular injury under Section 7.2 of the Act
Background
Dependency benefits were awarded to Petitioner James Renner, following his wife Cathleen's death from a pulmonary embolism. The workers' compensation judge determined that petitioner's claim was compensable under the standard governing cardiovascular injury or death, N.J.S.A. 34:15-7.2 (Section 7.2). Cathleen worked at AT&T for twenty-five years as a salaried manager. Although she had a "nine-to-five" job, at home she would sit at her computer and work all hours of the day and night to meet various deadlines imposed by AT&T. On September 24, 2007, Cathleen began working on a project at home in the evening. The following morning, she finished the project from home, and sent an e-mail to a co-worker at 10:30 a.m. At 11:34 a.m., Cathleen called 9-1-1 because she could not breathe. She was pronounced dead when she arrived at the hospital, and the cause of death was that of a pulmonary embolism. The compensation judge ruled that Cathleen had suffered a work injury, and he awarded workers’ compensation benefits pursuant to Section 7.2. On appeal, AT&T argued that there was no evidence that (1) Cathleen's work effort or strain was in excess of the wear and tear of her non-work activities, and that (2) Cathleen's work activities caused the pulmonary embolism.
Holding
The Appellate Division affirmed the judge’s determination that Cathleen had suffered a work injury. The Court noted that the Judge had properly applied Section 7.2 which states that:
In any claim for compensation for injury or death from a cardiovascular or cerebral vascular causes, the claimant shall prove by a preponderance of the credible evidence that the injury or death was produced by the work effort or strain involving a substantial condition, event or happening in excess of the wear and tear of the claimant's daily living and in reasonable medical probability caused in a material degree the cardiovascular or cerebral vascular injury or death resulting therefrom.
Based on this language, the Court determined that the question to be addressed was whether Cathleen's lack of movement at work was more severe than her lack of movement in her daily living,and whether the inactivity at work caused her pulmonary embolism in a material way. The Court then ruled that Cathleen's work inactivity was, in fact, greater than her non-work inactivity, and that her inactivity at work caused her pulmonary embolism in a material way due to her having to spend unusually long hours at her home computer, thereby causing the blood clot to develop as a result of her work inactivity.
Any questions regarding this case can be directed to Oliver M. Bather at 610-332-7006 or (obather@tthlaw.com).
Sentinel Insurance Company v. Earthworks Landscape Construction, L.L.C.
(App. Div. # A-0748-10T1; Decided August 16, 2011)
The Compensation Division is an appropriate forum to resolve a declaratory judgment action seeking to void a workers’ compensation insurance policy
Background
In 2008, Robert Tutela, a member and employee of Earthworks Landscape Construction, L.L.C., filed an application with Sentinel Insurance Company for workers' compensation coverage. Representations were made that Earthworks hired independent contractors to perform tree work, and that all of the Earthworks employees performed their work at ground level. Based on additional representations by Tutela, Sentinel issued a workers' compensation policy to Earthworks. In June 2008 Earthworks contracted with Daystar-USM Exterior Services to remove 50 dead oak trees from a building site in Toms River. On June 27, 2008, Tutela was seriously injured when he fell from a bucket truck while pruning trees 35 feet off of the ground. Tutela brought a workers' compensation claim, and Sentinel disclaimed coverage "due to material misrepresentations made by the claimant himself as a member of the insured entity." Sentinel then filed a declaratory judgment action in civil court seeking rescission of the policy because it would never have issued the policy but for Tutela's misrepresentations. The Court refused jurisdiction indicating that it was within the discretion of the judge of compensation to make such a determination as it related to a workers’ compensation matter. In the workers' compensation action, the judge of compensation ruled for Tutela and ordered Sentinel to pay medical and temporary disability benefits. However, though ruling that the policy was valid under the Workers' Compensation Act, the compensation judge suggested that it did not have jurisdiction to void the policy on the basis of misrepresentations. On appeal from the civil action, Sentinel argued that the judge of compensation, who awarded benefits to Tutela, did not have the power to make a declaratory judgment regarding the effectiveness of the insurance policy, while Tutela argued that he did.
Holding
In rendering its ruling, the Appellate Division cited a 1968 New Jersey Supreme Court case which suggested that a judge of compensation had the power to rule on issues of insurance coverage. Ultimately, the court agreed with the reasoning of Professor Arthur Larson, Larson's Workers' Compensation Law § 15004 (2010), which indicates that, when it is ancillary to the determination of the employee's right, the compensation commission has authority to rule upon a question relating to the insurance policy, including fraud in procurement, mistake of the parties, reformation of the policy, cancellation, existence, or validity of an insurance contract, coverage of the policy at the time of injury, and construction of extent of coverage. Based on this analysis, the court held that it was proper to transfer the issue of Sentinel's right to rescission to the judge of compensation. The court did not hold that the Law Division did not have a simultaneous power to rule on this issue, but rather, that it made more sense to vest both the compensation claim and coverage claim in one forum, namely the Division of Workers' Compensation. The court, therefore, reversed the judge of compensation's ruling declining to consider the rescission issue.
Any questions regarding this case can be directed to Oliver M. Bather at 610-332-7006 or (obather@tthlaw.com).