LOIS Senior Associate Stephen T. McLinden and Paralegal Avery A. Dover secures a fraud win in a New York Workers’ Compensation case. This long-running claim, open for more than six years for head and neck injuries, took a critical turn after an IME concluded the claimant was permanently totally disabled and incapable of basic activities such as sitting, standing, lifting, or performing daily tasks. Given the severity of these reported limitations, Attorney McLinden recommended surveillance, which revealed the claimant engaging in activities inconsistent with the IME findings, including driving to the airport, lifting luggage, performing outdoor household chores, retrieving packages, and spending hours washing and detailing his car while repeatedly bending and stooping.
Based on this evidence, Attorney McLinden pursued litigation on Section 114-a violation. After months of litigation, including investigator testimony, circulation of surveillance footage, and an IME Addendum significantly reducing the disability opinion, the Law Judge found that the claimant violated Section 114-a and disqualified the claimant from all wage replacement benefits from the start of the surveillance forward, including any post-classification payments, thereby avoiding a potential lifetime permanent total disability award and underscoring the value of surveillance in appropriate cases. As a result of this favorable outcome, the Carrier’s exposure is significantly reduced.
