Anthony Iler Gets Major Win in Fraud Trial

Lois Law Firm recently won a Board Panel Decision which implemented a lifetime ban on future indemnity benefits as a result of the claimant’s commission of fraud within the meaning of WCL § 114-a. The claim was previously established for injures to the head, neck, back post-concussion syndrome and a consequential left clavicle injury resulting from a 2013 accident.

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Claim Disallowed Based on Lack of Timely Notice pursuant to Section 18

The Claimant was a delivery man in his position for approximately eight months at the time of the alleged injury. The Claimant alleged in his initial C-3.0 that he suffered back pain, but was not sure how it happened. He alleged that he woke up the next morning and could barely move. He assumed it must have been because of his job duties. He told his doctor about two months later that the pain began five months earlier and that there was no inciting incident. However, as the Claimant began to treat with the same doctors, he eventually stated that an acute accident occurred, that he tripped while loading boxes, fell, and injured his lumbar spine. The employer denied the claim, as the Claimant failed to provide notice of the accident until over two months after the alleged accident. Further, despite denying prior treatment to the lumbar spine, the Claimant had a history of sciatica.

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Jessica Blydenburgh Wins Fraud Trial

Claimant was involved in a July 11, 2021 work-related accident established for injury to the right shoulder. No prior shoulder injuries were disclosed in the completed C-3. Claimant reported to her treating physician that she underwent a previous right shoulder MRI but could not remember involvement in any significant injury that precipitated the MRI. Upon presentation to the IME physician, Claimant reported medical conditions and surgeries dating back to the 1980s but reported no prior right shoulder injury or medical care.

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Anthony Iler Shows Claimant Fabricated Claims, Complete Disallowance at Trial

Attorney Anthony Iler successfully obtained a complete disallowance at trial despite the presence of an IME conceding causal relationship for injuries to the neck, back, left wrist and left ankle. The claimant alleged he was injured at a construction site in February of 2021. LOIS initially raised all available defenses and argued that the claimant was the employee of a demolition sub-contractor rather than its insured client. Further investigation revealed substantial “red flags” pointing to the fact that no accident actually occurred.

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Claim Disallowed Based on Claimant’s Concealment of Prior Injuries

The Claimant was a delivery man in his position for over thirty years. Over the course of those thirty years, the Claimant filed over ten claims against the same employer, most of which were established. Among those claims were acute injuries to both knees, which resulted in surgery for the right knee in the 1990s. The Claimant received SLU awards to both knees when the Claimant was at MMI.

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LOIS Prevails in Fraud Trial; Wins Permanent Penalty

Lois Law Firm secured a fraud penalty against a claimant, which resulted in the claimant being permanently barred from receiving any Workers’ Compensation benefits because of his failure to disclose work-activities and giving false testimony at prior hearings. LOIS attorney, Dan Gillis, was able to achieve this though effective cross-examination of the claimant and claimant’s witnesses along with a persuasive argument that the claimant failed to disclose his work-activities after the accident and outright denying any such work-activities at prior hearings and to the Carrier’s IME physicians.

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PTSD Claim Disallowed Over Fear of Contracting COVID

The Claimant was a delivery driver that alleges in March 2020, he had panic attacks due to making deliveries in crowded grocery stores at the start of the pandemic. He alleged that as a result of the stress at the time, he was diagnosed with both post-traumatic stress disorder. A few days after the panic attacks, the Claimant went on leave and never returned to work.

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