Winning Results

LOIS obtains disallowances for two traveling claims with separate dates of loss. Attorney Alexa Cintron was able to highlight key inconsistencies for each alleged accident, as the Claimant submitted contradictory C-3 forms alleging injury to different body sites in each file. The Claimant also withheld key information about prior accidents to his own doctors and failed to discuss specific facts about the alleged injuries with those doctors.

LOIS Attorney Kristine Rosales successfully argued in written summations for the disallowance of PTSD and anxiety disorder claims following depositions of the IME and claimant’s medical provider. The claim is currently established for injuries to the neck, back, and bilateral knees, and the claimant was seeking to have the case amended to include PTSD and anxiety disorder. During the depositions, Attorney Rosales elicited damaging concessions from the claimant’s medical witness, which zeroed in on her role in the practice. Said witness ultimately conceded that she did not examine the claimant and that her role was limited to documentation for the clients. Further, she conceded that her documentation was based on another clinician’s examination of the claimant. She even conceded that her role in the practice does not include provision of mental health treatment. While she confirmed that there were mental health diagnoses for the claimant, she could not explain the positive findings indicated in her reports.

The Claimant had an established neck injury related to a 2022 work accident. The Claimant was treated and returned to work full duty. Four days later the Claimant allegedly was injured again when he was standing at a supervisor’s station (wooden structure) when it was hit by a forklift and it caused the structure “to move 2 feet”. As a result, the Claimant alleged injuries to the neck and low back. There was a video of the accident. The Claimant sought treatment with the same doctors who treated him for his prior accident and sought treatment for both claims.

The Claimant alleged he sustained an elbow injury while covering another employee months prior to providing notice to his Employer. Initially, we interpreted the claim filed as an acute injury since the Claimant specified a period of time he alleged injury. At the Pre-Hearing Conference, it was clear that opposing counsel wanted the claim to be reviewed as an occupational disease, suggesting that through repetitive use of his work duties, the Claimant injured his elbow. Opposing counsel knew that if the claim were interpreted as a specific injury, there would be evident notice issues given the late reporting. To counter opposing counsel’s position, LOIS attorney Tomer Lehr took a holistic approach and defended the claim from both an occupational disease and specific injury perspectives. Accordingly, at trial, the Claimant was asked questions meant to demonstrate that he allegedly sustained an injury on a specific day at work yet failed to bring attention to the Employer until many months after the fact.

The claimant alleges that she was injured on January 3, 2022, wherein she was picking up multiple trays at once and the trays fell on her right hand. This claim was established to the right hand/wrist, right middle finger and right ring finger. The claimant’s treating doctor filed a permanency report dated January 3, 2023 in which he diagnosed the claimant with a 18.75% SLU of the right wrist, a 24% SLU of the right ring finger, and a 34% SLU of the right middle finger. Total exposure value if all SLUs were applied would be $34,887.53. LOIS attorney Natalia Verde obtained an IME on April 11, 2023 and the independent examiner diagnosed the claimant with a 0% SLU based on the full range of motion in the right wrist and 3rd and 4th digits in the right hand.

A LOIS Litigation team comprised of Partner Christian Sison and Paralegal Brianna Nicolas obtained a reclassification win for a Hotel client earlier this year. In L.Q. v W.N.Y.T.S., the claimant had been found to have sustained a permanent total disability, entitling her to lifetime indemnity benefits. The Hotel transferred the case for LOIS to provide a different approach, which resulted in using surveillance to argue that the claimant was no longer suffering from the permanent total disability.

LOIS obtains a no attachment to the labor market finding after arguing the claimant failed to conduct a timely, diligent, or persistent work search. The claimant was classified as having a permanent partial disability but was deemed unattached to the labor market and was directed to produce evidence of a timely, diligent, and persistent work search.