New York • New Jersey • Pennsylvania • Connecticut • Missouri • Illinois • Maryland • North Carolina
Goldberg Segalla’s Workers’ Compensation Practice Group was founded on the premise that the prevailing model of defending employers in workers’ compensation claims was inefficient and inadequate. We developed our own unique practice model, one that involves handling each claim from beginning to end, staying abreast of even the most minor changes in interpretive language used by the courts, and developing strategies tailor-made for each unique situation.
We put this approach to work — with a proven track record of results — for clients in a wide range of industries throughout New York, New Jersey, Pennsylvania, Connecticut, Missouri, Illinois, Maryland, and North Carolina.
Our team, which is more than 60 lawyers strong, represents both self-insured employers and employers with large retentions and deductibles, as well as insurance carriers, third-party administrators, municipalities, and boards of education. We have an extensive record of successfully defending private and public clients in a broad range of industries, including (to name just a few): trucking, manufacturing, retail, hospitality (including both restaurants and hotels), food production, long-term care, home health care, public services, and education. We also frequently counsel employers on ways to proactively reduce risk of worker injuries.
We have successfully handled cases involving both major and minor injuries, in both the accident and occupational disease contexts. Our extensive experience includes (but is by no means limited to) those involving slips and falls, motor vehicle accidents, carpal tunnel syndrome, hearing loss, psychological stress, cardiac events, death, and dependency benefits. We have achieved determinations for our clients as well as favorable global settlements involving the claimants in workers’ compensation cases and related third-party actions. We have also successfully investigated and litigated workers’ compensation fraud claims.
One of the distinctive ways we provide clients with a strong competitive advantage is through advocacy during the Medicare Set-Aside (MSA) process. Our team includes a Medicare Set-Aside Consultant, certified from the International Commission on Health Care Certification, which allows us to bring exceptional strategic insight to cases involving MSAs and the allocation for the future medical costs of an individual on (or soon to be on) Medicare following settlement. We don’t merely prepare and submit MSAs; we put our exceptional experience in this area to work toward identifying and negotiating the lowest defensible MSA amount with the Centers for Medicare and Medicaid Services (CMS), which can significantly reduce the ultimate settlement amount of a claim. We can handle the MSA process on claims nationwide.
We handle workers’ compensation litigation before all appropriate government agencies and courts and in all forums of alternative dispute resolution in the states where this team practices. Through our work handling regular and trial hearings, permanency determinations, and testimony of claimants, employer witnesses, and medical experts, we strive to resolve cases as completely and efficiently as possible, with a focus on bringing them to final closure for the defendant:
- New York: We routinely practice before the New York Workers’ Compensation Board and have extensive experience handling stipulation settlement conferences, mandatory mediations, and §32 settlement agreements.
- New Jersey: We defend clients before the New Jersey Division of Workers’ Compensation and in every workers’ compensation vicinage in New Jersey, and we regularly achieve §20 orders approving settlement.
- Pennsylvania: We represent our clients’ interests before the Pennsylvania Workers’ Compensation Appeal Board and the Commonwealth Court of Pennsylvania, and regularly bring closure through Act 57 compromise and release (C&R) settlement agreements.
- Connecticut: We defend clients before commissioners in all eight districts of the Connecticut Workers’ Compensation Commission at informal, pre-formal, and formal hearings and settle cases through full and final stipulation agreements.
- Maryland: We represent self-insured and insured employers in all stages of litigation, including at hearings before the Maryland Workers’ Compensation Commission, in settlement conferences, and on appeal to the Circuit Courts of Maryland.
- Missouri: We represent employers and their insurers throughout Missouri in all stages of workers’ compensation proceedings, from hearings before administrative law judges, to appeals to the Labor and Industrial Relations Commission, and on appeals to the appellate courts.
- Illinois: Our workers’ compensation attorneys appear on behalf of employers and their insurers before arbitrators throughout the state, and they represent those employers and insurers on appeals to the Workers’ Compensation Commission.
- North Carolina: We practice before the North Carolina Industrial Commission on a daily basis. We have extensive experience handling mediations, clincher settlements, and hearings before Deputy Commissioners and the full Commission.
- Federal statutes: Our team also has extensive experience defending cases involving the federal worker-injury laws under the Longshore and Harbor Workers’ Compensation Act (LHWCA) and the Jones Act, each of which raises unique challenges for employers and insurance carriers. The LHWCA applies to certain maritime workers for injuries allegedly incurred upon U.S. navigable waters and/or at adjoining workplaces like wharfs and dry docks, and the Jones Act allows certain maritime workers to bring claims for maintenance and cure but also to bring negligence claims for their alleged work injuries.
We understand the priorities of self-insurers and the need to have matters resolved promptly and cost-effectively. That is one reason why we have formed excellent working relationships with an extensive network of experts who can assist in developing defenses to various claims. Our significant experience in working with risk managers allows us to find creative solutions to obstacles and help our clients meet their long-term objectives.
And because Goldberg Segalla offers valuable counsel and litigation experience in a broad range of practice areas, we are able to assist our clients in the full array of legal challenges that often arise in connection with workers’ compensation claims, such as complex lien, credit, and subrogation issues stemming from third-party claims; retaliation and other employment law issues; and insurance coverage issues. We value our relationships and welcome the opportunity to assist our clients in additional areas when those needs arise.
Opioid Impact Program
Goldberg Segalla offers a comprehensive Opioid Impact Program — OIP for short — that helps claims professionals to reduce claimants’ use of prescription medications and to identify and mitigate claims that have the potential to spiral out of control in terms of cost and exposure.
Our OIP employs an early identification strategy to educate claims professionals on the key indicators of potentially problematic cases involving opioids and prescription drugs. It also sets forth a specific protocol to limit new prescriptions for new and older cases, along with a detailed blueprint on how to isolate, identify, and reduce claims with high prescription medication costs.
Our Best Practices Approach
We believe our approach to handling claims creates unparalleled levels of preparedness and efficiency, which ultimately leads to better immediate results as well as greater long-term savings for the client. Fueled by our firm-wide Best Practices service philosophy — which puts the interest of the client first and emphasizes teamwork and the development of long-term relationships — our approach includes:
- Completing a comprehensive review of each file at the outset, in order to develop the best possible strategy
- Ensuring continuity in the file-handling process by keeping each file with the same attorney throughout the entire litigation process
- Thorough preparation for and participation in hearing appearances, with the goal of resolving all issues involved in the claim, not just a single issue
- Regular and productive communication with clients to provide risk/exposure evaluations and keep everyone on the same page
All this adds up to a better overall experience for employers, carriers, and third-party administrators — and a better way to help mitigate liability and bring the claim to a quicker resolution.
In addition, we regularly prepare workers’ compensation legal updates and conduct training sessions for our clients. Our Workers’ Compensation Quarterly newsletter provides a timely summary of court decisions and the latest news concerning workers’ compensation matters.