Category Archives: Workers Compensation

Trial Win: Lack for Medical Evidence in Chronic Inflammatory Response Syndrome Claim

LOIS attorney Joseph Melchionne was successful in getting the court to disallow a claim against our client in a matter in which the claimant alleged that she was bitten by a mosquito while on a work mission trip to Uganda, Africa in 2012, causing her to contract Malaria. The claimant argued that during her work-related trip to Uganda in 2012 and in the seven (7) years since, she has become permanently unable to return to work as a result of contracting Malaria and as a result of the Malaria she has suffered a myriad of co-morbid medical conditions such as Chronic Inflammatory Response Syndrome (CIRS), a brain tumor, postural orthostatic tachycardia syndrome (POTS), and other conditions. After subpoenaing over fifty (50) of the claimant’s treating doctors’ medical records, conducting medical depositions, and cross-examining the claimant at trial, the court found that there was no definitive documentary or medical proof connecting the claimant’s alleged case of Malaria to any of her complaints, and as such, the claim must be disallowed on the basis of insufficient medical causation. The court disallowed the claim in its entirety against the carrier.
Case: KB v. KC;
Court: Manhattan
Lois Attorney: Joseph Melchionne, Esq.

Video: Trial Attorneys on Pros and Cons of New York’s Mandatory Virtual Hearing Program

On March 25, 2019 the New York State Workers’ Compensation Board will complete its technology upgrade to all workers’ compensation courts throughout the state. This transition to mandatory, statewide virtual hearings caps off a year-long project by the Board to roll out virtual hearings across the State and make attorney check in through the virtual hearing system a requirement across the entire system. Lois Attorneys Christian Sison and Managing Partner Greg Lois discuss what this means for employers and carriers.

Continue reading Video: Trial Attorneys on Pros and Cons of New York’s Mandatory Virtual Hearing Program

Trial Win: Neck and Back Case Disallowed Despite IME Concessions

In a case decided March 18, 2019 the allegations of neck and back injury were disallowed despite two separate IME reports conceding causation. Although the case was established for schedulable sites pursuant to §21 despite “vast inconsistencies” in the claimant’s case – this win was the direct result of seeking to cross-examine the claimant’s physician immediately at the pre-hearing conference, and not waiting to “see what the IME says” (which is a common practice).
Case: TM v. SPC;
Court: Manhattan
Lois Attorney: Timothy Kane, Esq.

Trial Win: Repetitive Stress Injury Claims

Neck and back claim disallowed by the trial judge on March 18, 2019 as there was no causal relationship between the alleged injuries and the claimant’s work duties, due to the lack of distinctive features of her job duties which would have caused a repetitive stress injury. Likewise, there were no distinctive job duties described in her doctor’s testimony, and it was noted that the injuries could be degenerative in nature. Notably, the IME of the defense expert conceded neck and back repetitive trauma injuries.
Case: CS v. BGNRC; New York Workers’ Compensation Board
Court: Manhattan
Lois Trial Attorney: Timothy Kane, Esq.

Trial Win: Claimant Committed Fraud While Pursuing Benefits in New York

On March 15, 2019 LOIS attorney Joseph Melchionne was successful in obtaining a favorable Reserved Decision determining that the carrier does not have a legal obligation to provide the claimant and the court with covert video surveillance reports during litigation of fraud under WCL Section 114(a). At trial, Melchionne argued that the claimant violated Section 114(a) and committed fraud because covert video surveillance was obtained that revealed the claimant performing masonry work while maintaining to his doctors that he was unable to even perform the simplest activities of daily living. The claimant’s material representations to his doctors compelled his treating physicians to issue medical reports opining that the claimant was totally disabled. In this case, the court determined that the claimant’s conduct was so egregious that not only was it determined that the claimant was ineligible to receive indemnity benefits for prior periods of lost time, but the court also utilized the discretionary penalty to disqualify the claimant from receiving any future indemnity benefits.
Case: SO v. WCC;
Court: Manhattan
Lois Attorney: Joseph Melchionne, Esq.

Trial Win: Court Rules Owner Controlled Insurance Program Client Not Liable for Occupational Disease

In this complex occupational disease claim arising from the claimant’s work in construction, we were successful in defending the claim against our client (who held a wrap-up policy) before the New York Workers’ Compensation Board and arguing for liability to be imposed on a different employer/carrier. The claimant had worked for several different employers in the period leading up to his work stoppage and three different carriers, including our client, we placed on notice regarding potential liability. We took extensive testimony of the claimant and subpoenaed copious medical records before the Law Judge found our client was not liable on the claim. Our argument was two-pronged: 1) that our client was not the employer during the last injurious exposure; 2) that as the holder of a wrap-up policy, our client should not be found liable on an occupational disease claim, which should impose liability on the holder of the operational policy.

Case: AB v. OCIP Client;
Court: Brooklyn
Lois Attorney: Noah Pollack, Esq.