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Author: Matthew Jones

Home > Archives for Matthew Jones

New Jersey Jurisdiction Primer

09.19.2022

Each state within proximity of the Greater New York City area has distinct laws regarding workers’ compensation benefits. These laws can vary significantly regarding when and how much benefit a worker can collect, requiring a determination of jurisdiction as one of the first steps in reviewing a workers’ compensation claim.

 

What is jurisdiction?

In basic terms, jurisdiction is determined by looking at what meaningful contact the employee in question had within the state around the time of the injury. When a state is determined to have jurisdiction, that state’s legal representatives have a vested interest in the employee’s claim and the state’s laws regarding workers’ compensation will apply.

 

In some instances, jurisdiction will be clear but there will often be a variety of factors to consider when determining jurisdiction.

 

Common questions used to determine jurisdiction:

  • Where did the incident occur? If the accident occurs in the state of New Jersey, New Jersey will automatically have jurisdiction.
  • Where is the company’s headquarters? Jurisdiction may not automatically fall to the state or country in which a company is based.
  • Where does the employee live? The employee’s primary address or where they received mail could be a significant determining factor for jurisdiction.
  • What office or company building does the employee regularly report to? Given the proximity between New York and New Jersey, employees may live and work in different states.
  • Was the employee traveling on business at the time of the incident? Past cases have shown that even when traveling internationally, jurisdiction can fall to the home base of the employee.
  • Where did medical treatment occur? As medical treatment is not part of the employee’s job function, it is not typically a primary determining factor for jurisdiction but can affect future medical provider claims.
  • Were there any other parties involved in this incident? For example, the employee could have been traveling out of state on a contract for a third party.

 

How can companies assist with determining jurisdiction?

  • Keep accurate hiring records.
  • Regularly review physical hiring paperwork to ensure dates, addresses and details are easily identifiable.
  • Verify physical hiring records are transcribed correctly to digital forms.
  • Keep detailed accounts of employees traveling in and out of the state.
  • Make note of any unusual out-of-state situations. For example, conducting an interview or hiring an employee over the phone while in a different state could influence jurisdiction.

Jurisdiction Disputes

During a jurisdiction dispute, the parties involved in the workers’ compensation claim will look to make a case for the jurisdiction that benefits each of them more favorably. Further complicating matters, it is also possible for workers to collect benefits in more than one state.

 

In New York and New Jersey, jurisdiction disputes are common. The following are important areas of differentiation in terms of workers’ compensation benefits between the two states.

 

New York vs New Jersey

  • Wages: In New York, indemnity benefits, or lost wages that you would expect to be paid while recovering from a work-related injury/illness, are tax-exempt and are calculated as a 35% reduction from the employee’s gross salary to a maximum or minimum; New Jersey provides 70% of an employee’s average weekly wages before the injury.
  • Disability: In New York, compensation for permanent loss of use of an extremity (i.e., an arm or leg) is limited to a certain number of weeks based on a schedule loss of use (SLU); In New Jersey, claimants may receive a permanency award for their injury.
  • Treatment: In New York, respondents (in this case the employers) do not direct or control where an employee receives medical treatment; In New Jersey, the respondent controls treatment of the petitioner (in this case the employee) in an accepted workers’ compensation claim.
  • Out of office claims: New York has a “home office exception” for compensable accidents since 1968; New Jersey has several cases of work from home accidents which have been deemed compensable.

 

What is the impact of a jurisdictional dispute on a workers’ comp claim?  

A jurisdictional dispute can be costly to an employer, particularly when a company does not have sufficient insurance in the state in which jurisdiction is determined. In this case, the state’s Uninsured Employers Fund will assist with covering the costs of the workers’ compensation claims. The assistance the Uninsured Employer Fund can provide varies across all 50 states and employers that require its services can be sanctioned with high fines. For example, in New Jersey, companies can face fines up to $5,000 for each 10-day period without coverage and in New York companies can face up to $2,000 for each 10-day period without coverage.

 

Companies seeking expertise in workers’ compensation cases in New York and New Jersey should engage a specialist who knows the unique challenges of the local landscape. Jones Jones LLC has 100 years of experience in workers’ compensation law with offices in both New York and New Jersey to assist clients with jurisdictional disputes.

 

New Jersey Jurisdiction Primer

 

 

Filed Under: Blog

New NYS Workers’ Compensation Board Medical Treatment Guidelines

12.22.2020

Jones Jones LLC is closely monitoring the implementation of newly developed NYS Workers’ Compensation Board Medical Treatment Guidelines.

The new Guidelines cover the following body parts and conditions:

  1. Ankle and Foot
  2. Asthma
  3. Depression
  4. Elbow
  5. Hand, Wrist, and Forearm
  6. Hip and Groin
  7. Interstitial Lung Disease
  8. PTSD

 

Originally, the Board had a targeted date of implementation of January 1, 2021. Due to the Covid-19 crisis, the Board recently announced that they will set the new date of effectiveness to be a date to be determined in the future.

http://www.wcb.ny.gov/content/main/hcpp/MedicalTreatmentGuidelines/MTGOverview.jsp

Jones Jones LLC stands at the ready to assist you and your team in the training and onboarding necessary in order to become familiar with the new Medical Treatment Guidelines.

Contact us today to schedule a webinar on the newly developed Guidelines!

Filed Under: Blog

Is Your Law Firm Cyber Security Compliant?

10.04.2020

In 2018, the Department of Financial Services unveiled a comprehensive set of Cyber Security regulations in an effort to curtail growing threat posed to information and financial systems in today’s modern world. This new set of Regulations has significant reach as it not only affects institutions regulated by the Department of Financial Services who house nonpublic information like insurance carriers, but also the law firms those institutions partner with. The Regulations are comprehensive and are meant to provide a framework as to how your company to should maintain best-practices. The Regulations can be broken down into four (4) general areas: (1) Your policy, (2) Your program, (3) Annual Reporting and (4) Third Party Considerations.

  1. Policy

As an insurance carrier in New York, you must have a Cybersecurity Program that is designed to protect the “protect the confidentiality, integrity and availability” of your data. What this means is that your business has a way to identity, assess risks, and has an ability to act on, in a defensive manner, to a known threat. First, you must conduct a risk assessment of your company and in response to that risk assessment, draft a written policies and procedures approved by your Board of Directors or other senior management to address information security, system and network security, and business continuity among other things.

  1. Program

Each insurance carrier must appoint an individual tasked with enforcing their Cybersecurity policy, named the Chief Information Security Officer. This may be a member of your company or a third party, however if there is a third party, you must maintain direction and oversight of their activity to ensure compliance with the Regulations. The Chief Information Security Officer must file a report annually to your company’s senior management on your program and relevant cybersecurity risks.

The Department of Financial Services regulations stop short of outlining required cyber security technical requirements and instead instructs insurance carriers to set their own standards after their risk assessment. This makes compliance with the Regulation hard to clarify, as each carrier will have its own Program tailored to its cyber needs. However, the Regulation does instruct you to consider the following for your Program: annual penetration testing , bi-annual vulnerability assessments, an audit trail designed to detect and respond to threats maintained for five (5) years, written procedures, guidelines and standards that are updated to address new and emerging threats, multifactor authentication, data encryption of nonpublic information, periodic training and monitoring of staff and key personnel, and incident response plan in the event of a breach, and disposal of nonpublic information.

  1. Reporting

As an insurance carrier, you are required to file a report annual with the Superintendent certifying that you are compliant with the new Cybersecurity regulations. The Department of Financial Services reserves the right to audit your company to ensure compliance with the new Regulations. This is why having a written policy and copies of your Risk Assessment, vulnerability testing, and assessment of your law firm is critical. Failure to maintain these records may result in hefty fines levied against your company.

As a covered entity under the regulation, your vendors – of which Jones Jones LLC would be considered – also must comply with the new Cybersecurity Regulations as well. Law firms and vendors are considered “third party service providers” and since they receive non-public information, you must only partner with a law firm who has put into place protective and industry-standard protections. This partnership is critical as in the event of a cyber-threat, the onus is placed on you, the insurance carrier, to ensure and maintain airtight security practices of your law firms. The risk of partnering with a law firm that is not prepared to comply with the Regulations is enormous, and under New York Banking Law could result in fines up to $75,000.00 per day.

What should you do? If you have not already done so, you must audit the security of your law firms to ensure compliance with these Regulations. It is recommended by the Department of Financial Services that you review your law firms’ cyber security practices regarding the following at bare minimum: their access to nonpublic information, whether they have multifactor authentication, how their data is encrypted at rest and in transit, and their notification policy in the event of a breach on behalf of the law firm.

As Jones Jones LLC takes all of its partnerships seriously, we have completely revamped our own cyber security practices to ensure your claims data is not only adequately protected, but also industry-leading.

  • Jones Jones’s cybersecurity infrastructure was modeled after such industry best practices as the NIST Cybersecurity Framework, NIST Special Publication 800-53, and 20 CIS Critical Security Controls.
  • Data in transit is encrypted across our network. Data at rest is encrypted using AES 256 encryption.
  • All Jones Jones emails are configured with TLS encryption.
  • Access to Jones Jones systems require two-factor authentication.
  • Jones Jones has its information systems tested for vulnerabilities on a weekly basis.
  • Jones Jones infrastructure is reviewed and maintained by a Cybersecurity committee.
  • And so much more.

Partnering with a law firm that does not maintain such stringent requirements is a risk in it of itself. Rest assured your partnership with Jones Jones is safe.

Filed Under: Blog Tagged With: New York

Jones Jones LLC Is Proud to Announce the Opening of our New Jersey Workers’ Compensation Practice

04.15.2020

We would like to take this opportunity to thank you for playing such an important role in the rapid growth that we have experienced over the past few years.

Now it will be even easier for employers, insurance carriers, third party administrators and other businesses in New Jersey to gain access to the legal experience, innovation, efficiency and excellence that has made us a leading defense team in the workers’ compensation industry.

Clients of our New Jersey workers’ compensation practice expect to receive the same high quality, client-focused service that we have been providing in New York for over 100 years.

That includes:

  • One of the industry’s highest workers’ compensation settlement rates – a 75% claim closure
  • Responsive communication – we promise a 24-hour turnaround time for all communications.
  • An elite loss transfer recovery rate of 91.3% as compared to the industry average of 64% of amount sought.
  • And much more.

While Jones Jones LLC has a prestigious 100-year history, you can count on us to continue to evolve and expand so that you, our clients, always have responsive, convenient access to the superior legal service you need.

“Legal Defense Refreshed” is not just an empty slogan; we work hard every day to stay on the leading edge of workers’ compensation defense.

Ready to make a referral to our New Jersey workers’ compensation practice? Contacts us at clientservices@jonesjonesllc.com.

Filed Under: Blog, News Tagged With: New Jersey

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