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LOIS Proves No Employer-Employee Relationship, Disallows Suspicious Claim

LOIS Partner Joseph N. Melchionne secured a no-employee disallowance in a New York Workers’ Compensation claim. The Claimant alleged that he tripped while moving a door from one apartment to another while at work, causing several injuries. The Employer informed that it does not employ the Claimant, and the claim was controverted. The employer-witness testified that she was a vice president for the Employer and that the company did not ever employ the Claimant. She testified that the company performs work for restaurants, schools, and hotels, did not do business at the alleged accident location, and received no reports any work-related injuries. At the hearing, Melchionne aggressively cross-examined the Claimant regarding all issues of compensability, including issues of accident, notice, and causation of accident to alleged injury. The claimant testified that he worked for the Employer on the date of the alleged accident at a construction site, that his duties included cleaning jobsites and organizing materials at the sites, and that the apartment complex he was working at on the alleged date of the accident was empty and no one was living in the complex. The Claimant testified that he did not have to sign a sign-in sheet at the jobsite.

Following the Claimant’s testimony, Melchionne argued that the employer-witness testified that the Employer only performed cleaning services for restaurants, schools, and hotels and were not a construction company. He argued that the Employer never employed the Claimant, and that the Claimant did not produce any proof that he was ever paid by the company. He argued that pursuant to the Claimant’s own testimony, he worked on construction sites, which is inconsistent with the type of work that the Employer provides at restaurants, hospitals, and schools. The Law Judge determined that the Carrier successfully rebutted the WCL Section 21 presumptions of compensability by impugning the credibility of the Claimant and the evidence produced to support the claim. Thus, the Law Judge reasoned, the Claimant was not an employee of the insured on the date of the accident and disallowed and closed the claim in its entirety.

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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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