The claimant alleged a work-related left-arm injury in April 2024. During a deep medical investigation, LOIS Associate Elizabeth Pappas and Paralegal Emily Ostrowski located a report billed to private insurance showing a left-arm injury in a motorbike accident approximately six weeks earlier. After the carrier raised New York Workers’ Compensation Law § 114-a, the claimant denied the prior left-arm injury and asserted that the motorbike accident had involved the right arm instead.
The LOIS team persistently pursued the physician’s deposition despite scheduling resistance. The physician attributed the left-arm notation to transcription software but admitted having no independent recollection of the examination. The team then tested that explanation against the report itself and the surrounding medical evidence.
The Workers’ Compensation Law Judge found the physician’s explanation unpersuasive, determined that the claimant had violated Workers’ Compensation Law § 114-a, and disallowed the claim. The matter demonstrates the impact of searching beyond the workers’ compensation file, securing difficult testimony, and refusing to accept a convenient explanation that is inconsistent with the contemporaneous medical record.
