The claimant denied prior treatment involving the right leg and psychological conditions and failed to disclose a significant motor vehicle accident on the employee claim form and to treating providers. Records from that earlier accident later showed treatment to the same body part and psychological conditions at issue in the workers’ compensation claim, including treatment by a provider who also participated in the later claim.
Lois Law Firm Associate Ryan Wallace and Paralegal Samantha Barker paired that medical-history investigation with surveillance that contradicted the claimant’s reported need for a cane and claimed inability to drive. By organizing the prior records, sworn testimony, medical histories, and video evidence into a single factual presentation, the team demonstrated that the discrepancies were material to the payment and evaluation of benefits.
The Workers’ Compensation Law Judge found a violation of New York Workers’ Compensation Law § 114-a and permanently disqualified the claimant from future indemnity benefits in the claim. The outcome substantially reduced long-term exposure and illustrates why LOIS protocols require close comparison of prior medical history, current reporting, sworn testimony, and observed activity.
