LOIS Associate Erica M. Fersch successfully defended a Motion for Medical and Temporary Disability Benefits in a New Jersey Workers’ Compensation case. The case pertained to a 2018 accident, where the Petitioner alleged that he fell off the lift gate of his truck and suffered various neck, back, and right-sided injuries. Under this claim, the Petitioner received three (3) authorized operative procedures and then relocated to North Carolina prior to being released from authorized care. The Carrier continued to pay temporary disability benefits. Therefore, in her opposition, Attorney Fersch argued that the Petitioner and/or the Petitioner’s attorney intentionally misrepresented the facts of the claim to the Court, and that the Petitioner was not entitled to additional medical care due to his noncompliance with treatment.
While preparing for the conference on the Petitioner’s Motion, Attorney Fersch found that the question of causal relationship appeared to be a recurring theme prior to the operative procedures being authorized. She found that not only did the Petitioner have a similar (and much more extensive) accident approximately one (1) year prior to this date of loss, but the Petitioner was actively receiving treatment for that prior, unrelated accident months prior to alleging that he was hurt in the course and scope of our employment. In the prior, unrelated claim, the Petitioner’s symptomology and alleged resulting injuries were, verbatim, exactly the same. Moreover, the Petitioner received a settlement in that claim approximately three (3) months prior to this alleged accident and expressly denied any relevant prior medical history, injuries and/or pain to all of the treating doctors, the Carrier, and the Employer in our claim.
In light of these findings, Attorney Fersch requested a closed-door conference in order to discuss the fraudulent concealment and in an effort to get the Judge’s full attention as to the significance it has on the claim. During the conference, she read the Petitioner’s subjective complaints from the medical records in the prior claim along with the Petitioner’s complaints in our claim and expressly pointed out that the two documents were, word-for-word, the exact same. Attorney Fersch argued that the Petitioner intentionally concealed these facts and the prior, unrelated claim from all treating providers, the Employer, and the Carrier. Not only was the Petitioner’s Motion closed out on the papers with no fee being awarded and no medical treatment being ordered, but the Judge also directed the Petitioner to submit to expert examinations and ensured the Respondent that the appropriate credit would be awarded at the time of settlement.
