Winning Results

Anthony Iler Gets Major Win in Fraud Trial

Lois Law Firm recently won a Board Panel Decision which implemented a lifetime ban on future indemnity benefits as a result of the claimant’s commission of fraud within the meaning of WCL § 114-a. The claim was previously established for injures to the head, neck, back post-concussion syndrome and a consequential left clavicle injury resulting from a 2013 accident.

At multiple hearings, the claimant had testified that she had not engaged in any work activity. Meanwhile, claimant’s doctors consistently opined a temporary total disability. Through researching the claim, LOIS was able to identify a civil filing made on behalf of the claimant which sought to have the names of various co-owners removed from the title of her purebred dog. Among the civil filings was an Order to Show Cause in which the claimant sought immediate relief as there was a relatively short window to breed the dogs and the puppies could not be sold until the clamant held clear title.

Fraud was raised based upon the claimant’s misstatements regarding her condition and work status. At the resulting hearing, the claimant testified that the subject dog was merely a pet and that she had no intention to breed or sell any dogs. Mr. Iler argued that no sense could be made of the claimant’s civil action unless you start from the premise that the claimant intended to breed the dog and sell the resulting puppies. The Law Judge was persuaded that fraud occurred, but implemented only the mandatory penalty which disqualified the claimant from receipt of indemnity payments for a period of approximately 14 months.

The parties exchanged appeals wherein the claimant sought a finding that no fraud had occurred, and LOIS sought a lifetime ban from all future indemnity awards. The Board panel responded by issuing a unanimous Board Panel Decision which found the claimant’s conduct so egregious as to warrant a full lifetime ban, adopting the arguments advanced by Mr. Iler in his written submission.

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New York Workers’ Compensation Defense at Lois Law Firm

We represent insurance carriers, self-insured employers, third party claim administrators, and employers before the New York State Workers' Compensation Board. We handle cases from cradle-to-grave. We want to be by your side, moving cases aggressively to closure from the start of litigation all the way through to settlement.

We only assign one attorney and one paralegal to each case. This means that your team members always have one contact to go to for any questions. We do not have 'hearing attorney' or a 'negotiation attorney' or 'appeal department' or anything else! All of our attorneys handle all of those roles – meaning cases are not 'passed around' as they move through the litigation process. Your risk professional or adjuster always knows who is assigned – because the attorney does not change.

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