LOIS Associate Alexa Cintron and Paralegal Megan Pachner successfully won on the issue of WCL Section 114-a in a New York Workers’ Compensation case based on the Claimant’s failure to disclose a prior injury. Receipt of subpoenaed medical records showed that the Claimant was involved in a 2018 motor vehicle accident, which was prior to the 2023 work-related accident. As a result of the 2018 accident, the Claimant treated for the neck, back, and right knee, including undergoing a right knee surgery. It was alleged that because of his 2023 accident, there were injuries to multiple body sites, including the neck, back, and right knee.
However, despite the prior treatment, when filing his Workers’ Compensation claim Form C-3 for the 2023 accident, the Claimant denied suffering any prior injury to any similar body sites. Further, when the Claimant filled out the intake questionnaire for a May 29, 2024, appointment with the Carrier’s medical consultant, the Claimant again denied prior injury or surgical intervention to the overlapping sites. Attorney Cintron was also able to elicit testimony from Claimant’s own treating doctor, who testified that the Claimant never disclosed the existence of any prior injury to the doctor over the course of his treatment.
Overall, the Law Judge found Claimant’s testimony that he allegedly forgot about his prior injuries and surgery as not credible and found that the Claimant knowingly made a misrepresentation of a material fact by omitting information regarding his prior injuries to overlapping sites of injury. As a result, the Law Judge found a WCL Section 114-a violation, disqualifying the Claimant from receiving benefits as of the day the Claimant signed his C-3 form, and placed a permanent bar on the Claimant’s ability to receive further indemnity benefits.
