THE PLASTIC SURGERY CENTER, PA VS. MALOUF CHEVROLET-CADILLAC, INC. THE PLASTIC SURGERY CENTER, PA VS. LEONE INDUSTRIES THE WOODS O.R., INC. VS. LEONE INDUSTRIES STEVEN J. PARAGIOUDAKIS, M.D. VS. CAFÉ BAYOU MARC MENKOWITZ, M.D. VS. CAFÉ BAYOU (DIVISION OF WORKERS' COMPENSATION) (CONSOLIDATED) ( 2019 )


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  •                NOT FOR PUBLICATION WITHOUT THE
    APPROVAL OF THE APPELLATE DIVISION
    SUPERIOR COURT OF NEW JERSEY
    APPELLATE DIVISION
    DOCKET NOS. A-5597-16T1
    A-5603-16T1
    A-5604-16T1
    A-0151-17T1
    A-0152-17T1
    THE PLASTIC SURGERY CENTER,
    PA,
    APPROVED FOR PUBLICATION
    Plaintiff-Appellant,                  January 17, 2019
    APPELLATE DIVISION
    v.
    MALOUF CHEVROLET-CADILLAC,
    INC.,
    Defendant-Respondent.
    __________________________________
    THE PLASTIC SURGERY CENTER,
    PA,
    Plaintiff-Appellant,
    v.
    LEONE INDUSTRIES,
    Defendant-Respondent.
    __________________________________
    THE WOODS O.R., INC.,
    Plaintiff-Appellant,
    v.
    LEONE INDUSTRIES,
    Defendant-Respondent.
    _________________________________
    STEVEN J. PARAGIOUDAKIS, M.D.,
    Plaintiff-Appellant,
    v.
    CAFÉ BAYOU,
    Defendant-Respondent.
    __________________________________
    MARC MENKOWITZ, M.D.,
    Plaintiff-Appellant,
    v.
    CAFÉ BAYOU,
    Defendant-Respondent.
    ____________________________________
    Argued November 27, 2018 – Decided January 17, 2019
    Before Judges Fisher, Suter and Geiger.
    On appeal from the New Jersey Department of Labor
    and Workforce Development, Division of Workers'
    Compensation, Claim Petition Nos. 2014-28615, 2015-
    120, 2015-123, 2016-31914, and 2016-31913.
    A-5597-16T1
    2
    James A. Maggs argued the cause for appellants
    (Maggs & McDermott, LLC, attorneys; James A.
    Maggs, Sandra M. Guage and Benjamin D. Light, on
    the briefs).
    Ann P. DeBellis argued the cause for respondent
    Malouf Chevrolet Cadillac, Inc. (Ann P. DeBellis,
    attorney; Ann P. DeBellis and David P. Kendall, on the
    brief).
    David P. Kendall argued the cause for respondent
    Leone Industries (Ann P. DeBellis, attorney; Ann P.
    DeBellis and David P. Kendall, on the brief).
    Steven J. Currenti argued the cause for respondent Café
    Bayou (Law Offices of William E. Staehle, attorneys;
    Steven J. Currenti, on the brief).
    Susan Stryker argued the cause for amicus curiae
    Insurance Council of New Jersey (Bressler, Amery &
    Ross, PC, attorneys; Susan Stryker, of counsel; Susan
    Stryker and Michael J. Morris, on the brief).
    Steven Stadtmauer argued the cause for amicus curiae
    RWJ/Barnabas Health, Hackensack Meridian Health
    and The Valley Hospital (Celentano, Stadtmauer
    Walentowicz, LLP, attorneys; Steven Stadtmauer,
    Nancy A. Cifalino and Kristen Ottomanelli, on the
    brief).
    The opinion of the court was delivered by
    FISHER, P.J.A.D.
    In 2012, the Legislature amended N.J.S.A. 34:15-15, granting the
    Division of Workers' Compensation (the Division) exclusive jurisdiction over
    A-5597-16T1
    3
    claims brought by medical providers for payment of services rendered to injured
    employees.     These appeals, which we now consolidate, question whether,
    through its silence, the Legislature intended – via this 2012 amendment – to
    apply the two-year statute of limitations, N.J.S.A. 34:15-51, contained in the
    Workers' Compensation Act (the Act),1 or whether the Legislature intended to
    leave things as they were and continue to apply the six-year statute of limitations
    for suits on contracts, N.J.S.A. 2A:14-1, to such claims. We conclude that
    subjecting medical-provider 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.      So, we reverse the
    judgments that dismissed these medical-provider claims.
    The details of these cases need not clutter this opinion. Each medical
    provider filed petitions in the Division for payment of services rendered to
    employees of the respondent employers. And each medical provider filed its
    claim more than two years from the date of each employee's accident but less
    1
    N.J.S.A. 34:5-1 to -146.
    A-5597-16T1
    4
    than six years from the claim's accrual.2 In interpreting N.J.S.A. 34:15-15 so as
    to require application of the two-year time-bar of N.J.S.A. 34:15-51, the same
    compensation judge dismissed all these actions. The medical providers appeal,
    arguing that the compensation judge misconstrued the significance of the 2012
    amendment.
    Before the 2012 legislative amendment that generated the question
    presented, a medical provider was entitled to file a collection action for payment
    of its services in the superior court and had no obligation to participate in a
    patient's pending compensation action. See Univ. of Mass. v. Christodoulou,
    
    180 N.J. 334
    , 350-51 (2004). But, as the Court held in Christodoulou, when an
    employee pursues a claim in the Division for compensation benefits, a medical
    provider's Superior Court collection action "must be transferred" to the Division.
    
    Id. at 352
    . The Court directed such transfers in the future not for jurisdictional
    reasons and not because of the then existing statutory framework but because
    such transfers vindicate the goals "of handling claims efficiently and avoiding
    2
    The triggering date for the time-bar in N.J.S.A. 34:15-51 is the date of the
    employee's accident but for the time-bar in N.J.S.A. 2A:14-1, it is the date of
    the action's accrual.
    A-5597-16T1
    5
    duplication of efforts." 
    Ibid.
     See also Med. Diagnostic Assocs. v. Hawryluk,
    
    317 N.J. Super. 338
    , 350 (App. Div. 1998).
    With an apparent intent to more formally herd all medical-provider claims
    into the Division, 3 the Legislature amended N.J.S.A. 34:15-15, declaring that
    "[e]xclusive jurisdiction for any disputed medical charge arising from any claim
    for compensation for a work-related injury or illness shall be vested in the
    [D]ivision."   The Legislature said nothing more, expressing no thought on
    whether it had also simultaneously altered the time within which a medical-
    provider claim must be commenced. So, whether N.J.S.A. 34:15-15 implicitly
    incorporated a legislative intent to subject medical-provider claims to the statute
    of limitations contained within the Act, or whether the enactment left the
    timeliness of such actions as it existed prior to the amendment, is the primary
    issue in these appeals.
    3
    In 2010, the Task Force on Medical Provider Claims, which was formed by
    the New Jersey Department of Labor and Workforce Development, issued a
    report observing that there had been an increase in medical billing disputes
    between insurers and medical providers and, consequently, a delay of such
    matters in the Division and a lack of uniformity in the administration and
    adjudication of such claims by the Division. See N.J. Dep't of Lab. and
    Workforce Dev., Task Force on Med. Provider Claims (Nov. 8, 2010), which
    may                      be                     found                     at
    https://www.nj.gov/labor/forms_pdfs/wc/pdf/110810_TaskForce_MedicalProvi
    derClaims.pdf.
    A-5597-16T1
    6
    When a dispute about a statute's meaning arises, a court's "paramount
    goal" is to ascertain the legislative intent; the "best indicator of that intent is the
    statutory language."     DiProspero v. Penn, 
    183 N.J. 477
    , 492 (2005).                In
    examining a statute for its intended meaning, a court ascribes to the Legislature's
    words "their ordinary meaning and significance," and, when an enactment is
    "plainly-written," a court will not "rewrite" or "presume that the Legislature
    intended something other than that expressed by way of the plain language."
    
    Ibid.
     Not one of the participants to this appeal argues the 2012 amendment to
    N.J.S.A. 34:15-15 clearly or plainly expressed how the timeliness of medical-
    provider claims would thereafter be determined. There can be no doubt that the
    Legislature said nothing about changing the time-bar previously applicable to
    medical-provider claims. Instead, the participants offer only their surmisals of
    what they believe the Legislature's silence meant.
    According to respondents – the employers in these workers' compensation
    matters – the 2012 amendment implicitly subjected the appellant medical
    providers' claims to the statute of limitations contained within the Act – a statute
    which requires that "[e]very claimant for compensation under [the Act]" submit
    a verified petition to the Division "within two years after the date on which the
    accident occurred." N.J.S.A. 34:15-51. They argue that because, with the 2012
    A-5597-16T1
    7
    amendment, medical providers must now commence their claims in the
    Division, N.J.S.A. 34:15-15, they thereby become – a fortiori – "claimants for
    compensation under [the Act]" and, so, their claims must be commenced within
    two years of "the accident"; in other words, in respondents' view, all those who
    seek relief in the Division are "claimants for compensation" and the claim of
    "[e]very claimant for compensation" is governed by the Act's two-year time bar.
    While this argument possesses some superficial appeal, appellants' argument
    that the Legislature did not likely intend that result is more convincing.
    First, the fact that the Legislature did not simply express that the Act's
    two-year time bar would apply to medical-provider claims is alone persuasive
    of its more likely intent to leave things as they were. It was well-established
    long before the 2012 amendment that the timeliness of medical-provider claims
    was governed by the general six-year statute of limitations, N.J.S.A. 2A:14-1
    (requiring that "[e]very action at law . . . for recovery upon a contractual claim
    . . . shall be commenced within 6 years next after the cause of any such action
    shall have accrued"). See Oldfield v. N.J. Realty Co., 
    1 N.J. 63
    , 66 (1948);
    Rabinowitz v. Mass. Bonding & Ins. Co., 
    119 N.J.L. 552
    , 557 (E. & A. 1938);
    Med. Diag. Assoc., 317 N.J. Super. at 350. And, there being no doubt about the
    application of N.J.S.A. 2A:14-1 to such claims by the time the Legislature acted
    A-5597-16T1
    8
    in 2012, we must assume that the Legislature understood this when amending
    N.J.S.A. 34:15-15. See Chase Manhattan Bank v. Josephson, 
    135 N.J. 209
    , 232
    (1994); Wright v. Village of South Orange, 
    79 N.J. Super. 96
    , 102 (App. Div.
    1963). One would therefore fairly expect that if the Legislature intended such a
    sea change it would have done so directly, not inferentially. Wright, 
    79 N.J. Super. at 102
    . Because the Legislature failed to explain or express itself on this
    precise issue, we cannot conclude it intended to so drastically alter existing legal
    principles.
    Second, the participants debate the significance of an earlier draft of the
    bill amending N.J.S.A. 34:15-15. If enacted, that draft would have imposed a
    duty on the Division "to provide procedures to resolve those disputes, including
    a system of binding arbitration and procedural requirements for medical
    providers or any other party to the dispute." Sponsor's Statement to A. 2652
    (May 10, 2012). In his written decision, the compensation judge viewed the
    deletion of this language from the final draft as revealing the Legislature's belief
    that existing procedures – such as N.J.S.A. 34:15-51 – were already in place for
    the future management of medical-provider claims in the Division. We reject
    this. If anything, the belief that the Legislature was already satisfied with
    existing procedural requirements for these claims more logically suggests it
    A-5597-16T1
    9
    intended that the six-year statute of limitations, which undoubtedly applied to
    medical-provider claims prior to the amendment, would continue to apply after
    the amendment was enacted.
    Third, and most obvious, is the fact that the Legislature made no alteration
    to N.J.S.A. 34:15-51 when it amended N.J.S.A. 34:15-15. Respondents, and
    amici who line up on their side, believe the Legislature intended to incorporate
    medical providers into the existing claimant-for-compensation category of
    N.J.S.A. 34:15-51 without saying so. That category, however, was always
    understood as referring only to employees. Other provisions in the Act clearly
    equate "claimant" with "employee." 4 And, the Act defines "compensation" as
    that to which the employee is entitled for a work-related injury as determined
    by "the schedule[s] contained in [N.J.S.A. 34:15-12 and 34:15-13]"; those
    schedules have no rational bearing on the methodology to be applied to
    determine when and to what amount a medical provider should be compensated.
    To accept respondents' theory, we would not only have to assume the Legislature
    meant to expand its preexisting view of "claimant" but also its preexisting view
    4
    As pointed out by amicus medical facilities, many provisions of the Act are
    phrased in ways that unmistakably equate "claimant" with "employee" and
    cannot sensibly be viewed as incorporating medical providers. See N.J.S.A.
    34:15-7.2, -12(c)(23), -28.2, -33.3, -34, -41.1, -43, -50, and -64(a)(2)(a).
    A-5597-16T1
    10
    of "compensation," when the Legislature remained silent on both points
    altogether.
    And, fourth, we are most persuaded that the Legislature intended to leave
    unaltered the time within which medical-provider claims must be commenced
    because the Act's two-year time-bar simply doesn’t fit. N.J.S.A. 34:15-51
    requires that a petition for compensation must be filed within two years of "the
    accident." Because there can be no doubt that "the accident," as used in this
    statute, relates only to the date the employee's work-related injury occurred, the
    idea that the timeliness of a medical-provider's claim should be gauged by the
    passage of time from the employee's accident seems nonsensical. It's safe to say
    that there would be – if this shorter statute of limitations applied – numerous
    times in which the window within which medical providers would be required
    to assert their claims would expire before their claims accrued. Is it not likely
    that at times an employee might be treated by a medical provider for a period
    greater than the two-year period following the worker's accident or even not be
    treated by a particular medical provider until after two years elapsed from the
    work-related accident? In seeking a reasonably plausible interpretation of the
    Legislature's amendment, are we really to assume the Legislature intended to
    create a situation where a medical provider's right to pursue a legitimate claim
    A-5597-16T1
    11
    might actually be extinguished before it even accrued? Absent greater evidence
    than its silence, we refuse to assume the Legislature intended to make such a
    significant and incongruous change to the time-bar applicable to medical-
    provider claims.5
    Undaunted by this roadblock in their theory, respondents, and the amici
    who have taken their side, argue that we should conclude the two-year time-bar
    – when applied to medical-provider claims – does not apply in the same way
    that it does when the claim is asserted by an employee notwithstanding the
    statute's plain language. They claim that the triggering date should not be the
    worker's accident but the date of the medical provider's service to the employee.
    There are a number of fallacies in this contention. To start, this argument
    eviscerates respondents' seminal contention that all those who file claim
    petitions in the Division are "claimants for compensation" and all are,
    accordingly, subject to the Act's time-bar. If all claimants for compensation are
    5
    Amicus Insurance Council of New Jersey argues that N.J.S.A. 34:15-41
    demonstrates an intention to impose a two-year time-bar on medical providers.
    We see no merit in this contention. N.J.S.A. 34:15-41 merely declares that "[i]n
    case of personal injury or death all claims for compensation on account thereof
    shall be forever barred unless a petition is filed . . . as prescribed by [N.J.S.A.
    34:15-51]." This statute was enacted in 1911 and last amended in 1931. So,
    one can only wonder how it sheds light on the Legislature's intent in enacting
    the 2012 amendment.
    A-5597-16T1
    12
    to be treated alike, why is it necessary – in order to reach that conclusion – to
    so significantly alter the manner in which the time-bar should be applied to some
    of those claimants?    By arguing that the time-bar operates differently for
    medical-provider claims – that the action accrues on the date of service instead
    of the employee's accident – the respondents must concede that medical
    providers are different types of claimants than employees.
    But, even more damning, in making this argument respondents believe we
    should, by judicial fiat, provide an alternate interpretation of the plain and
    unambiguous language of N.J.S.A. 34:15-51 to fit their theory. They would
    have us judicially engraft a phrase onto N.J.S.A. 34:15-51 to include an
    alternative triggering date for medical-provider claims. They ask us to declare
    that N.J.S.A. 34:15-15 should now be understood to mean that a medical
    provider must file its claim either, as the statutes declares, within two years of
    the date of the employee's accident or, as respondents would have us insert into
    the statute, "within two years following the service rendered."6 In taking such a
    6
    We are mindful that other events may trigger a timely action by a claimant for
    compensation. These alternative events make even clearer that the Legislature
    constructed this statute only for claims made by workers. For example, a
    claimant and the claimant's "employer" may agree for compensation and the
    claimant may commence a claim within two years of the "failure of the employer
    to make payment pursuant to the terms of such agreement." N.J.S.A. 34:15 -51.
    A-5597-16T1
    13
    step, we would not be interpreting the statute; we would be rewriting – likely
    perverting – what the Legislature enacted. See State v. Clarity, 
    454 N.J. Super. 603
    , 608 (App. Div. 2018). Although courts may at times engage in "statutory
    surgery" to preserve a legislative enactment from some unconstitutional taint,
    State v. Natale, 
    184 N.J. 458
    , 485-86 (2005); Town Tobacconist v. Kimmelman,
    
    94 N.J. 85
    , 104 (1983), our holding does not implicate constitutional concerns;
    so we may not utilize that scalpel. Even so, judicial surgery is undertaken to
    reshape the Legislature's language only to preserve what the Legislature meant.
    That is not what respondents seek. They 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. The relief respondents are after must be
    pursued in the legislative branch, not here. Absent some clearer expression from
    Since a medical provider has no "employer" in this context, these alternative
    events have no application to a medical-provider claim. The statute provides
    another exception: "repair or replacement of prosthetic devices shall not be
    construed to extend the time for filing of a claim petition." 
    Ibid.
     This provision
    further reveals that the Act's statute of limitations was limited with the intent
    only to apply to workers, not their medical providers.
    A-5597-16T1
    14
    the Legislature, the timeliness of medical-provider claims is to be assessed by
    resort to N.J.S.A. 2A:14-1.
    When ascertaining whether legislation clear on one point also implicitly
    impacted some other point, we sometimes find ourselves "in a kind of
    hieroglyphic world, where the real thing was never said or done or even thought,
    but only represented by a set of arbitrary signs." Edith Wharton, The Age of
    Innocence 42 (1920). To be sure, there are times when legislative intent might
    be gathered from less than clear statements and, in those cases, we apply
    statutory-interpretation tenets to develop an educated estimate about what the
    Legislature likely intended. But, here, we find nothing but legislative silence
    on the point in controversy; not even "a set of arbitrary signs" supports
    respondents' argument.
    The judgments under review are reversed and the matters remanded for
    further proceedings on these timely claims. 7
    7
    Because we decline to interpret the statutory scheme so as to impose a two-
    year time limitation on medical-provider claims, we need not reach the medical
    providers' argument that any holding that the two-year time-bar applies should
    be given prospective effect. We also need not consider the medical providers'
    argument in some of these cases that respondents' failure to plead the statute of
    limitations constituted a waiver of the defense or respondents' contention that
    this argument was abandoned.
    A-5597-16T1
    15