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WINNING RESULTS: LOIS Prevails on Recreational Injury Defense

Christian Sison recently secured a disallowance of a claim filed by a Sales Executive of a technology company that LOIS defended. The claimant suffered admittedly serious injuries when he left a Happy Hour event hosted by an entity who did work with the technology company. Specifically, the claimant was walking the streets of Manhattan when he was struck by 2 motorized bicyclists.

Christian investigated the claim with the help of a representative from the technology company, as well as the third-party administrator. In speaking to the company representative that would later testify at trial, Christian secured a key piece of evidence: a screenshot of the event invite. This nullified any attempted argument that the technology company organized the event or made it mandatory for its employees.

At trial, Christian argued that the injury, while understandably unfortunate, was not compensable under the Workers’ Compensation Law. He presented 3 reasons to disallow the claim. First, he argued that Section 10 applied to bar off-duty injuries, because the claimant was not required to attend the Happy Hour, the claimant was not compensated for attendance, and the technology company did not sponsor the event. Second, Christian noted that even if the Happy Hour was deemed work-related, the injury occurred after the claimant had left to go home. Third, he argued that the claimant had not met his burden of proving medical causal relationship, because the claimant did not disclose a prior injury sustained while working for a different employer. The Judge was satisfied with the disallowance argument, ruling that the claimant was not entitled to Workers’ Compensation benefits.

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The 2023 edition of Gregory Lois’ practical, up-to-date, and easy-to-understand guide to workers’ compensation claims in New York.

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Learn More About New York Workers’ Compensation Defense at LOIS

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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