Claimant was involved in a July 11, 2021 work-related accident established for injury to the right shoulder. No prior shoulder injuries were disclosed in the completed C-3. Claimant reported to her treating physician that she underwent a previous right shoulder MRI but could not remember involvement in any significant injury that precipitated the MRI. Upon presentation to the IME physician, Claimant reported medical conditions and surgeries dating back to the 1980s but reported no prior right shoulder injury or medical care.
Investigation into Claimant’s medical history was done and revealed that she was involved in an August 3, 2010 motor vehicle accident with multiple injuries, including to the right shoulder and an eventual 2012 right shoulder arthroscopy. LOIS attorney, Jessica Blydenburgh, raised WCL Section 114-a violation and the case was set for trial.
During cross-examination, testimony was obtained from the Claimant in which she attempted to evade every question, eventually claiming that she recalled having an unknown procedure on her shoulder in the past and she may or may not have received other treatment. At the conclusion of Claimant’s testimony, we directed the Law Judge to Claimant’s C-3, individual medical records from her treating physicians outlining her medical history, and the intake and narrative report from carrier’s IME which were devoid of any mention of a prior right shoulder injury. We argued that Claimant’s attempt to blame her omissions on a simple failure to recall held no merit, as she was able to provide a medical history for other conditions dating back 40 years to her physicians. We further argued that her knowing and repeated omission of prior right shoulder injury and treatment (including surgery) constituted an egregious violation of WCL 114-a, warranting the imposition of mandatory and discretionary penalties. The Law Judge agreed, finding a clear violation of WCL 114-a based on the “pattern of failure to disclose outlined in carrier’s summation.” All awards were suspended and the parties will return for a decision on penalties.
