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(This syllabus is not part of the opinion of the Court. It has been prepared by the Office of the Clerk for the convenience of the reader. It has been neither reviewed nor approved by the Supreme Court. Please note that, in the interests of brevity, portions of any opinion may not have been summarized).

COLEMAN, J., writing for a majority of the Court.

    This appeal addresses the question of whether a doctor who was hired as an employee of a company to treat its workers' compensable injuries pursuant to the Workers' Compensation Act can be sued in the Superior Court of New Jersey, Law Division, for malpractice arising from negligent medical treatment, or whether the immunity afforded co-employees by the Act extends to the doctor, requiring the injured employee to seek relief through the Division of Workers' Compensation (“Division”).

    Plaintiff was a pressman for the New York Times Company (“Times”). He incurred injuries to his left elbow, left knee and left leg when he fell from a ladder while performing his duties. The Times maintained its own medical facility, and plaintiff was treated for his injuries by defendant Dr. DePietro in the facility for approximately one year. Because plaintiff experienced persistent pain in his left thigh, an x-ray and MRI were performed approximately ten months after the accident. The medical tests revealed a lesion. Plaintiff was referred to an orthopedic oncologist who performed a biopsy of the mass and diagnosed cancer.

    Plaintiff filed a petition with the Division for the injuries incurred when he fell from the ladder. That claim was still pending in the Division when plaintiff filed this malpractice action against Dr. DePietro and other medical professionals. The trial court granted Dr. DePietro's motion for summary judgment, holding that the defendant was a fellow employee and therefore immune from a tort action pursuant to the Workers' Compensation Act. Thereafter, plaintiff's workers' compensation claim for the injuries resulting from his fall was resolved by entry of an order approving a settlement in which plaintiff was awarded 10" of his left leg for residuals of a hamstring pull. The order also reflected the parties' stipulation that the cancer was not causally related to plaintiff's employment or his ladder accident.

    After entry of the order approving settlement of the ladder-injury claim, plaintiff filed a motion to vacate the order granting summary judgment to Dr. DePietro in this malpractice action. The motion was denied by the trial court. After the claims against all other defendants were resolved and the order granting summary judgment to Dr. DePietro became final, plaintiff appealed the order denying the motion to vacate. The Appellate Division affirmed the trial court's order in a published opinion, 319 N.J. Super. 89 (1999), holding that plaintiff could not maintain a tort action against Dr. DePietro for failing to diagnose the cancer during his treatment of plaintiff's compensable injuries. The court adopted the position of the majority of courts in the United States that an injured employee may not maintain a malpractice action against a co-employee physician for the negligent aggravation of his or her existing injury.

    Plaintiff filed a Petition for Certification and shortly thereafter an application in the Division for review or modification of his disability award. The Court granted the Petition and addressed both the malpractice claim and the status of plaintiff's settled workers' compensation claim.

HELD:    A worker may not maintain a tort action against a medical practitioner who is also an employee of the injured worker's employer-owned-and-operated health care facility for harm caused during the treatment of the employee's work-related injury. The injured worker's exclusive remedy for the alleged malpractice is to pursue the claim in the Division.

1.    Where a worker is claiming that his compensable injury was aggravated by the professional negligence of a co-employee medical practitioner, the claim is to be treated as an accident that arose out of and in the course of employment within the meaning of N.J.S.A. 34:15-7, which does not require proof of negligence. However, to establish compensability for plaintiff's claim that the defendant failed to diagnose cancer in a leg he was treating for muscle strain, plaintiff must prove negligence before a Judge of Compensation in the Division. (Pp. 6-11)

2.    The Court rejects plaintiff's claim that a company doctor in a medical facility owned by an injured worker's employer acts in the dual capacity of co-employee and physician and therefore owes the injured worker an independent duty of care, breach of which would permit a tort action. A contrary holding would burden the employer indirectly with common-law damages superimposed upon its workers' compensation liability by reason of either a legal, moral or practical obligation to indemnify the sued doctor, or with the expense of carrying insurance to cover the personal liability of the doctor. N.J.S.A. 34:15-8, which extended immunity under the Act to co employees, was intended to eliminate such concerns. (Pp. 11-12)

3.    Since plaintiff's employer concedes and the Court concludes that the alleged malpractice constitutes an accident under N.J.S.A. 34:15-7, that portion of the order approving settlement of plaintiff's workers' compensation claim that stipulated the cancer was not causally related to plaintiff's employment or his ladder accident, entered pursuant to N.J.S.A. 34:15-20, is vacated so that plaintiff can pursue his claim against Dr. DePietro in the Division. (Pp. 12-14)     

    The judgment of the Appellate Division dismissing the tort action is AFFIRMED, and the matter is REMANDED to the Division for further proceedings in accordance with this opinion.

     JUSTICE STEIN, dissenting, contends that the Court should deny co-employee immunity, pursuant to N.J.S.A. 34:15-8, to company doctors for their negligent treatment of employee-patients, and that workers should be permitted to pursue their tort claims against company doctors in the Law Division.

CHIEF JUSTICE PORITZ and JUSTICES O'HERN, GARIBALDI, and VERNIERO join in JUSTICE COLEMAN'S opinion. JUSTICE STEIN filed a separate dissenting opinion in which JUSTICE LONG joins.
    
    

DONALD HAWKSBY and JOANNA HAWKSBY, his wife,

    Plaintiffs-Appellants,

            v.

JOSEPH A. DEPIETRO, M.D.,

    Defendant-Respondent,

            and

WALTER URS, M.D., MATTHEW GARFINKEL, M.D., WILLIAM H. ROSS, D.O., METUCHEN ORTHOPAEDIC GROUP, JOHN DOE, M.D. 1-50, JANE DOE, M.D. 1-50, JOHN DOE, R.N. 1-50, JANE DOE, R.N. 1-50, JOHN DOE
1-50, JANE DOE 1-50 and JOHN DOE CORP. 1-50, (Fictitious Names),

    Defendants.

Argued November 29, 1999-- Decided July 25, 2000

On certification to the Superior Court, Appellate Division, whose opinion is reported at 319 N.J. Super. 89 (1999).    

E. Drew Britcher argued the cause for appellants (Leonard & Butler, attorneys).

Francis E. Borowsky, Jr., argued the cause for respondent (Monte, Sachs & Borowsky, attorneys; Mr. Borowsky and Michelle A. Monte, on the brief).

Christopher B. Leitner submitted a brief on behalf of amicus curiae Donald Hawksby as Workers' Compensation Petitioner (Shebell & Shebell, attorneys; Raymond P. Shebell of counsel).

    The opinion of the Court was delivered by
COLEMAN, J.
    This case revisits the issue of whether there should be tort liability for co-employee physicians. The question raised is whether a doctor who is also an employee of an injured worker's employer may be sued in the Law Division for medical malpractice for allegedly injuring that worker while providing authorized medical treatment for a compensable accident. The Law Division held that the action was precluded based upon immunity under the New Jersey Workers' Compensation Act (Act), N.J.S.A. 34:15-8, and that the exclusive remedy was to pursue the claim in the Division of Workers' Compensation (Division). The Appellate Division affirmed in a published opinion. 319 N.J. Super. 89, 102 (1999).
    We hold that whenever a worker is treated for a work connected condition by an authorized doctor or nurse, who is also an employee of the injured worker's employer-owned and -operated health care facility, the injured worker's exclusive remedy for alleged malpractice is to pursue the claim in the Division.

    On July 23, 1997, plaintiff moved in the medical malpractice action, under R. 4:50-1, to set aside the summary judgment. The court denied this motion on October 24, 1997. That order was also interlocutory because the medical malpractice case had not been disposed of as to all parties. However, a stipulation of dismissal with regard to defendant, William H. Ross, M.D., the last party in the case, was filed on November 6, 1997. Plaintiff filed his timely notice of appeal on December 3, 1997, appealing from the October 24, 1997 order denying the motion to vacate the summary judgment entered on September 18, 1996.

    With few exceptions, we agree with the Appellate Division's legal analysis that led it to hold that “Hawksby may not maintain a tort action against Dr. DePietro based on his failure to diagnose the cancer during his treatment of Hawksby's compensable injury.” Id. at 102. The Appellate Division examined cases from around the country and concluded that “[t]he majority of the courts which have addressed this issue have concluded, as New Jersey has, that an injured employee may not maintain a malpractice action against a co-employee physician for the negligent aggravation of his or her existing injury.” Id. at 93 94.
    Hawksby filed his petition for certification on March 26, 1999. While that petition was pending, on April 4, 1999, he filed an application for review or modification, pursuant to N.J.S.A. 34:15-27, of his ten percent disability award for the left leg injury. That claim is still pending in the Division. We granted certification on May 26, 1999. 160 N.J. 479 (1999).

    With Kristiansen fresh in our minds, following oral argument, we requested each counsel who had handled the case in the Division “to submit a brief to the Court on the availability of Workers' Compensation on the ground that [Dr. DePietro's] failure to diagnose was an 'accident' within the intendment of [N.J.S.A. 34:15-7].” In response to that request, counsel for The Times conceded that no distinction should be made between a claim that an authorized treating physician has aggravated a work-related injury and that an aggravation of a non-work related condition was caused by that physician. Counsel reasons that in both instances, treatment would be administered by an authorized treating physician for compensable conditions and but for the injured employee's employment, the worker would not have been injured on the job and would not have been treated by the employer's authorized doctor, here Dr. DePietro. Counsel for the employer further concedes that plaintiff's claim of aggravation of his cancer, based on alleged professional malpractice under the workers' compensation no-fault system, is to be treated as an accident that arose out of and in the course of employment within the meaning of N.J.S.A. 34:15-7, without the necessity of proving negligence.
    Those concessions would be controlling in a case in which the worker was claiming that professional negligence aggravated the compensable injury being treated. Here, however, the worker is claiming that Dr. DePietro failed to diagnose cancer in the leg he was treating for a probable hamstring muscle strain. Under these circumstances, to establish compensability based on Dr. DePietro's alleged failure to diagnose the non-compensable cancer, the worker must prove professional negligence. Walck v. Johns-Manville Products Corp., 56 N.J. 533, 560-62 (1970). “[T]he doctor's malpractice would be an incident of the employment.” Id. at 562. We recognize that “our analysis makes compensation depend on proof of fault, in the face of the statute's direction that compensation be awarded or withheld 'without regard to the negligence of the employer.' R.S. 34:15 7. . . . But the fact is that in the circumstances of this case it is only the alleged negligence that makes the” aggravation compensable. Dudley v. Victor Lynn Lines, Inc., 32 N.J. 479, 495 (1960).
    Both Walck, supra, and Dudley, supra, involved claims of professional negligence that had to be prosecuted in the Division. The Judges of Compensation are at least as capable, if not more capable, of handling such claims as juries. Indeed, Florida and Virginia have adopted a workers' compensation approach for handling some of the more serious and complicated common-law medical malpractice claims. Fla. Stat. Ann. § 766.303 (West 1999) (dealing with birth-related neurological injury claims); Va. Code Ann. § 38.2-5002 (Michie 1999) (same); see also Randall R. Bovbjerg & Frank A. Sloan, No-Fault for Medical Injury: Theory and Evidence, 67 U. Cin. L. Rev. 53, 83 (1998) (discussing Florida and Virginia statutes); Practicing Law Institute, Medical Malpractice Developments 576 (1994) (same). See generally Randall R. Bovbjerg, et al., Administrative Performance of “No-Fault” Compensation for Medical Injury, 60 Law & Contemp. Probs. 71, 72 (1997) (“The first actual implementation of no-fault for medical liability occurred . . . in Virginia and Florida, largely under the workers' compensation model.”).

    We agree with the Appellate Division that the majority of jurisdictions that have addressed the issue align with the New Jersey rule that an injured worker may not maintain a malpractice action against a co-employee physician. Hawksby, supra, 319 N.J. Super. at 93-101. A contrary holding would result “in burdening the employer indirectly with common-law damages superimposed upon [its] workmen's compensation liability by reason of either a legal, moral or practical obligation to indemnify the sued [doctor], director, officer or supervisory employee, or with the expense of carrying insurance to cover the personal liability of such . . . personnel.” Miller v. Muscarelle, 67 N.J. Super. 305, 321 (App. Div.), certif. denied, 36 N.J. 140 (1961). These are some of the specific concerns N.J.S.A. 34:15-8 was intended to eliminate.

DONALD HAWKSBY and JOANNA HAWKSBY, his wife,

    Plaintiffs-Appellants,

            v.

JOSEPH A. DEPIETRO, M.D.,

    Defendant-Respondent,

            and

WALTER URS, M.D., MATTHEW GARFINKEL, M.D., WILLIAM H. ROSS, D.O., METUCHEN ORTHOPAEDIC GROUP, JOHN DOE, M.D. 1-50, JANE DOE, M.D. 1-50, JOHN DOE, R.N. 1-50, JANE DOE, R.N. 1-50, JOHN DOE
1-50, JANE DOE 1-50 and JOHN DOE CORP. 1-50, (Fictitious Names),

    Defendants.

    
STEIN, J., dissenting.
    The Court holds that plaintiff must pursue a medical malpractice claim in the Division of Workers' Compensation (Division) because the doctor who committed the alleged malpractice was provided by the employer. The Court affirms the lower courts' holding immunizing plaintiff's doctor from tort liability pursuant to N.J.S.A. 34:15-8 on the basis that the doctor was a fellow employee. That holding insulates company doctors from tort liability for negligent conduct, thereby depriving employees harmed by their negligence of an adequate forum to redress their injuries. I disagree and would adopt the dual capacity doctrine relied on by Justice Handler in Boyle v. Bireme, 93 N.J. 569, 570-77 (1983) (Handler, J., dissenting), and permit injured plaintiffs to assert medical malpractice claims against a co-employee company doctor.
    Moreover, in my view the Division is not the appropriate forum to litigate complex issues of medical causation. Plaintiff's claim should be litigated in the Law Division, the customary forum for the trial of medical malpractice claims.

                        I
                        A
    The Workers' Compensation Act (the Act) was enacted to insure that employees who are injured during the course of employment are compensated for their losses without having to prove the fault of the employer. Harris v. Branin Transp., Inc., 312 N.J. Super. 38, 46 (App. Div.), certif. denied, 156 N.J. 408 (1998). We have discussed previously the development of the Act and the purpose of workers' compensation legislation. Millison v. E.I. du Pont de Nemours & Co., 101 N.J. 161, 173-76 (1985). The Act “involve[s] a historic trade-off whereby employees relinquished their right to pursue common-law remedies in exchange for automatic entitlement to certain, but reduced, benefits whenever they suffered injuries by accident arising out of and in the course of employment.” Id. at 174. Thus, a balanced no-fault system was enacted where “employees would receive assurance of relatively swift and certain compensation payments, but would relinquish their rights to pursue a potentially larger recovery in a common-law action.” Ibid.
    In 1961, the Legislature amended the Act to provide for co employee immunity. L. 1961, c. 2. N.J.S.A. 34:15-8, as amended, provides fellow employees with immunity from tort liability for their own negligent acts in the workplace. Volb v. G.E. Capital Corp., 139 N.J. 110, 117 (1995); Wellenheider v. Rader, 49 N.J. 1, 9 (1967). The purpose of that amendment was to relieve employers from the burden of paying
        common-law damages superimposed upon [their]
        workmen's compensation liability by reason of
        either a legal, moral or practical obligation
        to indemnify [a] sued director, officer or
        supervisory employee, [and] the expense
        of carrying insurance to cover the personal
        liability of such supervisory personnel.

            [Miller v. Muscarelle, 67 N.J. Super.
            305, 321 (App. Div.), certif. denied,
             36 N.J. 140 (1961).]

See also Maggio v. Migliaccio, 266 N.J. Super 111, 116 (App. Div. 1993) (noting that N.J.S.A. 34:15-8 defense applies where plaintiff's employer provides workers' compensation benefits and would be responsible for plaintiff's injuries). Professor Larson notes that pursuant to workers' compensation laws an employer “gives up its normal defenses and assumes automatic liability” in exchange for immunity from employee common-law suits, and that that reasoning can be extended to a co-employee who is “entitled to expect in return for what he or she has given up . . . freedom from common-law suits based on industrial accidents in which that coemployee is at fault.” 6 Arthur Larson & Lex K. Larson, Larson's Workers' Compensation Law § 111.03[2] (2000). N.J.S.A. 34:15-8 thus protects fellow employees from common-law tort actions filed by workers who are injured or killed in the workplace. Volb, supra, 139 N.J. at 117; Wellenheider, supra, 49 N.J. at 9; Estrada v. Hendricksaw Corp., 302 N.J. Super. 262, 266 (App. Div. 1997); Bustamante v. Tuliano, 248 N.J. Super 492, 494 (App. Div.), certif. denied, 126 N.J. 385 (1991).
                            
                        B
    Because of the unique service provided by company doctors, some courts, although a distinct minority, wisely have declined to extend co-employee immunity to them and have adopted the dual capacity doctrine. Declaring that “[m]edical malpractice is not an inherent risk of the brewing business,” in Wright v. District Court, 661 P.2d 1167, 1171 (1983), the Supreme Court of Colorado held that a brewery employee whose back injury was aggravated by the malpractice of a company doctor could maintain a malpractice claim against the company doctor because the doctor's relationship with the employee
        was identical to that of a doctor in private practice with a patient. This relationship is distinct from the employment relationship; it entails different rights and duties. Clearly, a private doctor would be liable to [the employee] for malpractice. There is no logical reason to treat company physicians differently. Thus, the rule which immunizes employees from suits by their co-employees for negligence within the course of employment is inapplicable here.

                    [Id. at 417.]
    In Evers, the Court noted “that the difficulties of identifying, defining, and proving injury in certain types of medical malpractice cases justif[y] the application of a standard of causation that is more flexible than that used in conventional tort claims.” Id. at 413. Because of the inherent difficulty of proving negligence when the plaintiff is afflicted with a preexisting condition, the Court has continued to apply a lower burden-of-proof standard for plaintiffs to establish a prima facie case of negligence in this increasingly complex area of law. Gardner v. Pawliw, 150 N.J. 359, 377 (1997) (involving prenatal medical malpractice); Fischer v. Canario, 143 N.J. 235, 241 (1996) (concerning tumor misdiagnosis); Scafidi v. Seiler, 119 N.J. 93, 108-09 (1990) (involving prenatal medical malpractice); Dubak v. Burdette Tomlin Memorial Hosp., 233 N.J. Super. 441, 449 (App. Div. 1989) (concerning fatal internal bleeding).         
                        B
    The majority has determined that the Division is the exclusive forum in which plaintiff's claim should be tried. The Division, however, is a forum not well suited to the trial of a medical malpractice claim where an injured plaintiff must prove negligence in order to receive compensatory damages. The Division's customary function is to adjudicate causation in the context of no-fault claims. See Brock v. Public Serv. Elec. & Gas Co., 325 N.J. Super. 582, 588 (App. Div. 1999) (noting that workers' compensation court “was designed to establish a no fault system of compensation for workers who are injured or contract disease in the course of employment”). The Division's judges are unfamiliar with medical malpractice litigation and with the determination of whether a physician deviated from generally accepted standards of medical practice, an issue customarily submitted for resolution to a jury. In my view, the trial of plaintiff's malpractice claim belongs in the Law Division.

                        III

    For the reasons stated, I would reverse the judgment of the Appellate Division and remand the matter for trial in the Law Division. Justice Long joins in the dissent.
    

NO. A-104

DONALD HAWKSBY and JOANNA HAWKSBY,
his wife,
    Plaintiffs-Appellants,

        v.

JOSEPH A. DEPIETRO, M.D.,
    Defendant-Respondent,

        and

WALTER URS, M.D., et al.,
    Defendants.

DECIDED July 25, 2000 Chief Justice Poritz