LOIS Senior Associate Adam J. Lowenstein obtained a disallowance in a New York Workers’ Compensation claim. This claim involved a claimant who alleged injuries to his pelvis, back, and groin while lifting a box of meat work, and who had a prior back injury and recent medical issues unrelated to his job. Evidence showed claimant had been on leave for an unrelated leg condition, had repeatedly called out of work for said condition, and reported similar pelvic and testicular pain before the alleged work incident. Initial hospital records documented symptom onset a week earlier before the claimed accident, and there was no mention of any lifting event. A work-related mechanism first appeared only in a medical report, approximately a month after accident of record.
At trial, Attorney Lowenstein highlighted inconsistencies in the claimant’s account, including his evasiveness about seeking another leave of absence, coupled with lack of any documented work injury in the contemporaneous medical records. Moreover, Attorney Lowenstein emphasized that none of the medical providers who supported causality had reviewed the initial hospital records or the claimant’s prior treatment history. As a result, the Law Judge found a full disallowance based on failure to establish causal relationship. As a result of this favorable outcome, the Carrier is not liable for any incurred bills or any indemnity benefits associated with the disallowed claim.
