LOIS Partner Joseph N. Melchionne proved a fraudulent New York Workers’ Compensation claim. The Claimant alleged sustaining several injuries when he “slipped on a cart.” The Carrier accepted that an accident occurred and that notice was provided, but challenged causal relationship based upon undisclosed prior injuries. Melchionne raised a WCL Section 114-a for the Claimant’s failure to disclose. The parties then agreed to settle the claim, but the Claimant advised at the eleventh hour that she did not want to move forward with the agreement. Melchionne requested for a trial to address the WCL Section 114-a defense.
At the trial, the Claimant testified that he believed that he told some of his treating doctors that he suffered a prior accident in 2021 and that he did not others because he treated for injuries that were not related to the claim. When confronted with his prior treatment for the neck, back, shoulders, and right knee and hip, the Claimant testified that he only injured his right knee and right shoulder. However, on direct examination, he testified that he received diagnostic tests for back in association with his back, but injured his right knee and right shoulder. Following the Claimant’s testimony, the Claimant’s attorney argued that Melchionne’s defenses were frivolous and should be penalized with monetary sanctions.
Melchionne argued that the Claimant violated WCL Section 114-a based upon his misrepresentations regarding the nature and extent of his prior 2021 motor vehicle injury and treatment for the back, neck, and extremities. He argued that there were over 600 pages of prior medical and treatment records that contradicted the Claimant’s testimony. Melchionne argued that the mandatory and discretionary penalties must be assessed as a permanent ban on indemnity awards. The Claimant’s attorney interrupted Melchionne’s summations to argue that he made misrepresentations to the Court, to which Melchionne responded by providing the Law Judge with the exact document identification and page numbers for the subpoena responses and medical evidence that were relied upon to support the arguments.
The Law Judge agreed with Melchionne that the Claimant violated WCL Section 114-a, warranting the maximum mandatory and discretionary penalties. The Law Judge admonished the opposition, noting that the evidence in the record clearly established a basis for Melchionne’s arguments. The Law Judge noted that based on the fact that the Claimant did not disclose the nature and extent of his prior overlapping injuries and treatment and continued to testify in a deceptive manner, he assessed the Claimant with the mandatory and discretionary penalties resulting in a permanent disqualification of indemnity benefits.
