LOIS Associate Tomer Lehr and Paralegal Loriana Diaz resolved a claim in a New York Workers’ Compensation claim. The resolution was obtained in less than four months from assignment for less than half of the anticipated exposure. Upon receipt of the file, Claimant’s counsel had obtained a permanency report projecting over $50,000.00 in value, and an EC-81.7 had already been issued requiring a prompt Carrier response. Although permanency appeared ripe, Attorney Lehr discovered through due diligence that the claim was never formally established. This was on the grounds that the Board failed to issue a notice of indexing, rendering the Carrier’s denial timely. Attorney Lehr also uncovered evidence of a potential undisclosed intervening accident. Based on the mechanism of injury and procedural deficiencies, Attorney Lehr controverted the claim and filed the necessary pleadings to trigger a pre-hearing conference.
At the pre-hearing conference, Attorney Lehr maintained his position controverting the claim and raised Section 114-a violation stemming from the intervening accident. The Law Judge reviewed the file and noted the absence of initial medical records, ultimately marking the claim failure to prosecute. Armed with the leverage of a controverted claim, allegation of fraud violation, and the case having marked as failure to prosecute, Attorney Lehr aggressively pursued settlement. Following negotiations with multiple attorneys’ offices, Claimant accepted a full and final settlement for less than half of the originally anticipated permanency exposure. As a result of this favorable outcome, the Carrier’s exposure was significantly reduced.
