New Jersey § 34:15-15

§ 34:15-15.

The employer shall furnish to the injured worker such medical, surgical and other

treatment, and hospital service as shall be necessary to cure and relieve the worker

of the effects of the injury and to restore the functions of the injured member or

organ where such restoration is possible; provided, however, that the employer shall

not be liable to furnish or pay for physicians' or surgeons' services in excess of

$50.00 and in addition to furnish hospital service in excess of $50.00, unless the

injured worker or the worker's physician who provides treatment, or any other person

on the worker's behalf, shall file a petition with the Division of Workers' Compensation

stating the need for physicians' or surgeons' services in excess of $50.00, as aforesaid,

and such hospital service or appliances in excess of $50.00, as aforesaid, and the

Division of Workers' Compensation after investigating the need of the same and giving

the employer an opportunity to be heard, shall determine that such physicians' and

surgeons' treatment and hospital services are or were necessary, and that the fees

for the same are reasonable and shall make an order requiring the employer to pay

for or furnish the same. The mere furnishing of medical treatment or the payment thereof by the employer

shall not be construed to be an admission of liability. If the employer shall refuse or neglect to comply with the foregoing provisions of

this section, the employee may secure such treatment and services as may be necessary

and as may come within the terms of this section, and the employer shall be liable

to pay therefor; provided, however, that the employer shall not be liable for any

amount expended by the employee or by any third person on the employee's behalf for

any such physicians' treatment and hospital services, unless such employee or any

person on the employee's behalf shall have requested the employer to furnish the same

and the employer shall have refused or neglected so to do, or unless the nature of

the injury required such services, and the employer or the superintendent or foreman

of the employer, having knowledge of such injury shall have neglected to provide the

same, or unless the injury occurred under such conditions as make impossible the notification

of the employer, or unless the circumstances are so peculiar as shall justify, in

the opinion of the Division of Workers' Compensation, the expenditures assumed by

the employee for such physicians' treatment and hospital services, apparatus and appliances. All fees and other charges for such physicians' and surgeons' treatment and hospital

treatment shall be reasonable and based upon the usual fees and charges which prevail

in the same community for similar physicians', surgeons' and hospital services. When an injured employee may be partially or wholly relieved of the effects of a permanent

injury, by use of an artificial limb or other appliance, which phrase shall also include

artificial teeth or glass eye, the Division of Workers' Compensation, acting under

competent medical advice, is empowered to determine the character and nature of such

limb or appliance, and to require the employer or the employer's insurance carrier

to furnish the same. Fees for medical , surgical, other treatment, or hospital services that have been authorized by the employer or its carrier or its third party

administrator or determined by the Division of Workers' Compensation to be the responsibility

of the employer, its carrier or third party administrator, or have been paid by the

employer, its carrier or third party administrator pursuant to the workers' compensation

law, R.S.34:15-1 et seq. , shall not be charged against or collectible from the injured worker. Exclusive jurisdiction for any disputed medical charge arising from any claim for

compensation for a work-related injury or illness shall be vested in the division. The treatment of an injured worker or the payment of workers' compensation to an

injured worker or dependent of an injured or deceased worker shall not be delayed

because of a claim by a medical provider. No provider to the injured worker of medical, surgical, other treatment, or hospital

service pursuant to the workers' compensation law, R.S.34:15-1 et seq. , shall report any portion of their charges which are alleged to be unpaid, to any

collection or credit reporting agency, bureau, or data collection facility until:

(1) a judge of compensation within the Division of Workers' Compensation has fully

adjudicated the rights and liabilities of all parties, including the rights of the

claimant for payments pursuant to this section, section 1 of P.L.1953, c. 207 ( C.34:15-15.1 ), and section 1 of P.L.1966, c. 115 ( C.34:15-15.2 ), regarding the payment of these charges; or (2) a notice of a stipulation settlement

or an order approving settlement regarding the payment of these charges has been filed

with the court. Upon a finding that non-compliance with this paragraph has occurred, a judge of

compensation, in summary fashion, and in addition to such other provisions under the

workers' compensation law, R.S.34:15-1 et seq. , may: a. order the non-compliant provider to retract the medical, surgical, other treatment,

or hospital service charges reported to the collection or credit reporting agency,

bureau, or data collection facility; b. impose a fine on the non-compliant provider, not to exceed $5,000, payable to the

Second Injury Fund; c. order the non-compliant provider to pay a reasonable counsel fee in connection

with a claimant for payments who has suffered damage to credit rating due to the reporting

of unpaid medical, surgical, other treatment, or hospital service charges to a collection

or credit reporting agency, bureau, or data collection facility; d. order the non-compliant provider to take such steps as are necessary, within 30

days of the order, to rehabilitate the credit record of a claimant, with a showing

made to the court of the efforts made in that regard; and e. order the non-compliant provider to pay an award of damages to the claimant not

to exceed 25 percent of the medical, surgical, other treatment, or hospital service

charges reported by the non-compliant provider to the collection or credit reporting

agency, bureau, or data collection facility, the minimum award being $350.00.