LOIS Senior Associate Adam J. Lowenstein successfully obtained a fraud finding in a New York Workers’ Compensation claim. The claim involves an established claim to the neck, back, head, shoulders, feet, and for PCS and TBI. Approximately three years from the accident, surveillance showed claimant moving normally contradicting her reported limitations. The footage demonstrated significant functional abilities inconsistent with claimant’s medical portrayals. During fraud trial, claimant provided inconsistent explanations about her alleged restrictions, insisting she could not perform basic movements while also claiming extensive assistance with daily living.
After the presentation of the surveillance video, oral arguments ensued. Attorney Lowenstein highlighted the stark contrast between the claimant’s testimony, medical reports, and her actual abilities as shown on video surveillance. Attorney Lowenstein argued for mandatory and discretionary penalties under WCL Section 114-a based on the clear misrepresentations intended to obtain greater benefits. The Law Judge upheld the position of Attorney Lowenstein and imposed mandatory penalty, rescinding awards from the first date of misrepresentation onward, as well as discretionary penalty of permanent disqualification from future awards.
