Stancil v. ACE USA, ___ N.J. ___ (2012). “In this matter, we are asked to create a common law cause of action that would permit an injured employee, who is separately entitled to workers’ compensation benefits, to sue his employer’s compensation carrier directly for pain and suffering when it results from the carrier’s delay in payment for medical treatment, prescriptions, or related services.” So began the majority opinion by Justice Hoens in this case. By a 4-1 vote, the Court declined to create such a new cause of action, affirming both the trial court, which had granted defendant’s motion to dismiss, and the Appellate Division, which had affirmed that ruling. The majority concluded that such a cause of action would be inconsistent with the Legislature’s workers’ compensation scheme. Justice Albin dissented. Justice Patterson did not participate.
Justice Hoens gave three reasons for rejecting the proffered cause of action. “First, the workers’ compensation system has been intentionally designed to provide injured workers with a remedy for their injuries outside of the ordinary tort or contract remedies cognizable in our Superior Courts.” The workers’ compensation system was intended to replace court suits. Second, the Legislature recently rejected a broad authorization to pursue remedies in Superior Court, instead choosing to give compensation courts an expanded contempt power. “[W]e see no basis on which to substitute a different remedy for the one that the Legislature has chosen.” Third, the majority was concerned that this new remedy would ultimately displace the statutory system, again undermining the Legislature’s intention.
Justice Albin disagreed. He perceived that this case “represents a carrier’s intentional and unilateral shredding of the social compact embodied in the Workers’ Compensation Act.” He found no intent by the Legislature to “give shelter to a carrier that not only breaches its covenant of good faith and fair dealing with a worker but also inflicts on him a new injury outside the workplace.”
This is the second opinion in two days in which the Court declined to recognize a new cause of action for a plaintiff. Both opinions were by Justice Hoens. The first was unanimous, while the second drew only one dissenting vote. These two cases show that the current Court is not activist or tilted toward plaintiffs, despite complaints to that effect in some quarters.
Unfortunately, this means that injured workers are left without a remedy in a common situation – the carrier refuses or delays treatment and the employee has to go through the long process of litigating in comp court without getting treatment during the interim. It is a dicey situation for injured workers because the carriers often have little incentive to expeditiously approve and pay for needed treatments.