Winning Results

LOIS Attorney Secures Disallowance of Alleged Injury Immediately After Return to Work

Lois Law Firm was recently able to procure a disallowance from on controverted claim for the lumbar spine. The claimant alleged an injury to his lumbar spine on the day after returning from work a left shoulder injury. He stated that he had pain in the right hip and right leg and problems sleeping. He reported to the employer that he felt sore after returning to work and that it worsened as he continued to work over the next few weeks. He first sought treatment a few weeks later, denying any specific injury or incident.

At trial, LOIS Attorney, Jeremy Janis, sought to have the claimant confirm that there was a lack of inciting incident at work that caused his back pain. The claimant conceded that no specific activity or injury caused his pain and that it was overall soreness caused by him returning to work. He confirmed that he told his doctor that there was no specific incident. He conceded that he had a prior Workers Compensation case for the back a few years prior in which he was found to have degenerative issues to his back. He testified that he also had degenerative issues in the new claim. He testified that he did not trip, slip or fall and that the pain did not come on when lifting anything. In conjunction with the claimant’s concessions, the employer witnesses testified that the claimant waited to report his pain for a few weeks, and when he did, he did not indicate it was work-related. In fact, he stated the opposite, that it was degenerative.

Ultimately, based on the claimant’s testimony and lay witnesses, attorney Janis was able to procure a disallowance without the need for an IME or medical testimony. The Law Judge found that the claimant did not meet the criteria for either an acute injury or an occupational disease. He specifically noted that the testimony proved that there was no accident, that the claimant was out-of-work for a considerable amount of time due to shoulder surgery, and that the claimant complained of soreness due to returning to work.

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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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