Winning Results

LOIS Litigation and Appeal Teams Obtain Lifetime Fraud Penalty Against Claimant

A LOIS Litigation team comprised of Partner Christian Sison and Paralegal Brianna Nicolas obtained a reclassification win for a Hotel client earlier this year. In L.Q. v W.N.Y.T.S., the claimant had been found to have sustained a permanent total disability, entitling her to lifetime indemnity benefits. The Hotel transferred the case for LOIS to provide a different approach, which resulted in using surveillance to argue that the claimant was no longer suffering from the permanent total disability.

In that same case, the LOIS Litigation team also pursued fraud based on the surveillance, but the Law Judge rejected this application. Knowing that the claimant would appeal the reclassification finding, Christian and Brianna recommended an aggressive approach to appeal the fraud decision. Working with LOIS Senior Associate Addison O’Donnell to write the perfect brief, the Hotel client was rewarded by LOIS’ creativity when the reclassification finding was reversed, because the fraud finding was also reversed!

A Panel of the Review Division found that LOIS correctly applied the fraud statute when the claimant was surveilled performing yard work but also magnifying her symptoms by using a rolling walker to attend medical appointments. The Panel dutifully cited that the claimant embellished the degree of her disability, which led to a treating physician absurdly recommending that the Hotel pay for the claimant’s daughter to act as a home health aide. The Panel found this behavior to be egregious, eliminating all future indemnity exposure for the Hotel.

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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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