Winning Results

LOIS Reduced High-Exposure Construction Claim to Nuisance Value

Collaborating with Paralegal Karen Olarte, Partner Meisha Powell was able to successfully reduce a New York Workers’ Compensation construction claim to a negligible nuisance value. This was a complex case where a painter alleged falling from a paint bucket at a construction site and injuring multiple body parts. The Claimant alleged serious injuries to her neck, back, both shoulders, both elbows, both hands/wrists, both hips, both knees, both feet/ankles, and head. In preparing to defend this claim, Powell and her team began to gather evidence to rebut the Claimant’s allegations. Before trial, the Claimant submitted text messages, photos, and medical records to support her allegations.

During a multi-day trial, Powell painstakingly developed the record and chipped away at the Claimant’s credibility. During cross-examination of the Claimant’s doctor for which she relied, Powell was also able to call his credibility into question. The mechanism of injury described by the Claimant was in stark contrast to what her doctor understood the accident and resultant injuries to be. In fact, Powell obtained numerous concessions from the doctor, including not knowing how the Claimant actually injured most of the sites she was alleging. The Carrier’s medical examiner provided an opinion that the Claimant could not have sustained the injuries she was alleging from falling from a bucket. He opined that it was just not physically possible.

At trial, Powell was meticulous in tying together all the inconsistencies in the record, as well as making logical arguments when requesting that the claim be disallowed. Even though the Law Judge found the accident compensable with injuries to the neck, back, right shoulder, both knees, and both ankles, the Board Panel later reversed and rescinded the Law Judge’s decision finding that the Claimant sustained only a contusion (i.e., a bruise) to the left leg. The Board Panel found that it was unlikely that the Claimant sustained all the injuries alleged as a result of a trip and fall from a bucket. Needless to say, the disallowance of the neck, back, right shoulder, both knees, and both ankles resulted in a major reduction in exposure to the Carrier.

Employing additional tactics while litigating the compensability of the claim created leverage for a “full-and-final” WCL Section 32 settlement of a nuisance and negligible value. Meanwhile, pending the appeal filed by Powell and her team, the Carrier obtained covert surveillance footage of the Claimant. Powell and her team obtained numerous records of prior injuries that the Claimant had not disclosed involving overlapping sites that she was alleging. Powell raised a fraud defense on the basis of the covert surveillance and failure to disclose these priors. Thereafter, the Claimant requested settlement of the claim for six figures. But later, and only after the Board Panel had rescinded the establishment of multiple sites other than the leg bruise, Powell and her team were able to resolve this claim, significantly reducing the Carrier’s exposure for this claim. Creating a mountain of obstacles for the Claimant and putting her to prove her case resulted in this successful win for the client.

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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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