LOIS Partner Christian Sison and LOIS Paralegal Taylor Rodriguez were successful in obtaining a fraud finding after a lengthy set of trials in a New York Workers’ Compensation case. The Claimant was a hotel housekeeper that requested wage replacement benefits after having worked for a long period of time. Given that the requested benefits coincided with the start of the 2023 summer season, covert surveillance was initiated.
The surveillance videos proved that the Claimant used an assistive device only when presenting herself to medical appointments. It also displayed the Claimant’s extensive ability to drive when she denied the ability to do so. Sison prepared a fraud defense by meticulously comparing the Claimant’s complaints with the activities shown on surveillance video. Pressed with the evidence, the Claimant admitted that she was the individual caught on surveillance. After trial, the Judge rejected the Claimant’s “good day / bad day” argument and agreed with Sison that the Claimant presented herself in a way that augmented or exaggerated her disability.
