LOIS Associate Attorney Kristine Rosales and LOIS paralegal Andrea Hayles collaborated to successfully secure disallowance of a New York Workers’ Compensation claim. The Claimant testified that his face was struck by a hose pipe while cleaning it, that he lost consciousness for 20 minutes thereafter, and then that he fell off a roof. The employer-witness provided completely contrary testimony, noting that the Claimant had not reported any accident, worked an entire month after the alleged accident date, and then thereafter worked for another construction company while concurrently working for GrubHub and UberEats. Despite this contrary testimony, the Claimant’s argument was that the Independent Medical Examiner (IME) conceded causal relationship between the complaints and the alleged injuries.
Rosales argued that there was no basis to establish the claim. She reasoned that had the injuries been as substantial as Claimant purported them to be, he would have sought immediate medical attention and ceased all work entirely due to the gravity of the alleged mechanism. It was underscored that the Claimant’s initial medical report, which was 10 days post-accident, only mentioned an alleged diagnosis with the right eye. Rosales also directed the attention of the Law Judge to the Claimant’s lack of credibility as he testified that he has not returned to work after the accident but reported to the IME that he returned to work for a food delivery service. This corroborated with the witness testimony that the Claimant worked for GrubHub and UberEats. The Law Judge disallowed the claim in its entirety on the basis of the Claimant’s incredible testimony. As a result of the favorable outcome, the Carrier is not liable for any incurred bills, or any indemnity benefits associated to the disallowed claim.