Getting it Right on Workers' Comp Time Bar
We agree with the Appellate Division and the Supreme Court, and with the cogent and clearly stated reasons relied upon in the courts' opinions.
May 10, 2020 at 10:00 AM
4 minute read
When the Legislature amends a law to make substantive changes does it impliedly, without stating an intent, amend that law to change the time within which suit must be instituted under the amended act? That was the question before the Appellate Division in the case of Plastic Surgery Center v. Malouf Chevrolet-Cadillac, Inc., 457 N.J. Super. 565 (App. Div. 2019), in a Workers' Compensation Act context.
In 2012, the Legislature amended N.J.S.A.34:15-15 to provide the Division of Workers' Compensation with exclusive jurisdiction to decide medical provider claims for payment of services rendered to injured employees. Prior to 2012, health-care providers were entitled to file their actions for such services in the Superior Court. If, however, the employee filed a workers' compensation action, there was an obligatory transfer of their suit to the division for the purpose "of handling claims efficiently and avoiding duplication of effort."
In streamlining the process, by amending the compensation act to provide that health care provider suits be filed directly in the division, the Legislature did not address the time within which the medical provider's claim must be commenced. Would those suits be subject to the two-year period in the Compensation Act, applicable to employee claimants seeking workers' compensation benefits, or would they remain subject to the general six-year statute of limitations to which they had been subject for decades?
The amendment included no language indicating whether the third-party medical service providers, suing on a contract action, had now become "claimants" as defined in the Compensation Act and, therefore, obligated to follow the time limitation of the division, which for "claimants" bars claims filed more than two years after the accident which resulted in injury.
The Supreme Court in a Feb. 3, 2020, decision affirmed the Appellate Division's finding that the six-year statute remains the one governing such suits, "substantially for the reasons expressed in that court's opinion," with the obvious reminder that, although "the Legislature did not expressly address the statute of limitations" it was "of course free to do so in the future." We agree with the Appellate Division and the Supreme Court, and with the cogent and clearly stated reasons relied upon in the courts' opinions.
First, silence of the Legislature as to a substantial procedural provision, when enacting a substantive amendment, reveals its likely intent to leave procedural things as they were rather than by implication to drastically alter a well-settled legal principle. Secondly, the employee claim for compensation resulting from a compensable accident is discrete from a claim for subsequent medical treatment, which might extend for more than the two-year "claimant" period. Further, treatment by a specific medical provider might not even begin until two years have elapsed from the work-related accident, so under the insurers' two-year limitation theory a claim for services might actually be extinguished before it even accrued.
To quote the language of the Appellate Division, the "two-year time-bar simply doesn't fit" the context of a compensation scenario, so that timeliness of a medical provider's claim "gauged by the passage of time from the employee's accident seems nonsensical."
As the Appellate Division also colorfully wrote: "We conclude that subjecting medical-provided claims to the two-year time-bar would be like jamming a square peg into a round hole, and that to reinterpret the two-year time-bar to fit such claims would require the reshaping of the edges of this square peg contrary to principles of judicial restraint."
It clearly appears that any other interpretation of the plain and unambiguous language of the two-year period just does not fit a third-party claim for services. The insurers' theory, arguing for the two-year period, would have required unjustified judicial grafting of a non-stated procedural change to a substantive amendatory language. As concluded by the Appellate Division: "[The insurers] do not ask that we remove some part of the statute to avoid a constitutional infirmity; they seek instead to have us transplant into the statutory body a method for ascertaining the timeliness of a medical-provider claim never expressed nor likely contemplated by the Legislature. We decline the invitation."
A good lesson in statutory construction wrapped in a well-crafted and easily understandable opinion.
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