Winning Results

LOIS Secures Disallowance During Employer-Employee Relationship Trial

LOIS Associate Kristine Rosales and Paralegal Andrea Hayles obtained a major disallowance of a New York Workers’ Compensation claim. The Claimant alleged a fall, injuring the head, neck, back, left shoulder, left arm, left hip, and left knee. Multiple carriers were implicated in the claim. On direct examination, the Claimant repeatedly testified that he was employed by the employer represented by Attorney Rosales. He testified that he was hired by a contractor and he only received payment in cash for services rendered. On cross-examination, Attorney Rosales questioned the Claimant about the individual who hired him, as well as his basis for implicating the employer. The Claimant conceded that his basis was the logo of the employer that was at the job site. When asked for any supporting documentation indicating that he was employed, he conceded that he had nothing. The Claimant testified that the contractor who hired him was also the supervisor whom he notified of the accident. However, when asked for the name where his supervisor worked for, he conceded that he did not know.

Attorney Rosales moved for a disallowance based on the Claimant’s failure to establish employer-employee relationship and the overall evidence on record supporting that the claim is fabricated. Attorney Rosales also pointed out that the only evidence that supported Claimant’s allegation that he was an employee of the employer was a sign that was at the alleged accident site, which does not constitute employer-employee relationship.

The Law Judge ultimately disallowed the claim as to all the Carriers. The Law Judge based her decision on the Claimant’s unreliable testimony, which was inconsistent with the C-3 and the initial medical records. The Law Judge also found no sufficient evidence of employer-employee relationship. As a result of this favorable outcome, the Carrier is not liable for any incurred bills, or any indemnity benefits associated to the disallowed claim.

Download the New York Workers’ Compensation Law Handbook

Download Our New York Workers’ Compensation Law Handbook

The 2023 edition of Greg Lois’ practical, up-to-date, and easy-to-understand guide to workers’ compensation claims in New York.

This book is designed for employers, attorneys, claim adjusters, physicians, self-insured employers and vocational rehabilitation workers.

Download Now

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.

Learn More

Get articles delivered to your inbox, once a month.

Subscribe Today!