In this case the plaintiff filed a claim on October 11, 2022, requesting total right hip arthroplasty with a Sept. 7, 2022, medical report to support the claim. In the Oct. 11 claim, the plaintiff complained of an injury sustained at work in April of 2022. Vaikness and team filed form FROI-04 First Report of Injury-Denial, raising issues in controversy including failure to report accident timely, no causal relationship and no compensable accident/not in course and scope of employment. On June 15, 2023, the workers’ compensation law judge (WCLJ) authorized the left total hip replacement, accepting an original oral notice of injury and excusing timely notice due to the claimant not appreciating the severity of the injury.
On June 21, 2023, Vaikness and her team requested a review of the decision filed. The team argued the case was improperly established due to the claimant failing to provide proper notice of the accident pursuant to WCL § 18 and not providing a valid excuse for their failure to provide notice. In the review the workers’ compensation review board found the claimant did not provide written or oral notice of the accident to their employer within 30-days of the accident. With the board’s finding, the amended decision filed on June 21, 2023 was reversed and the claim was disallowed pursuant to WCL § 18.
The success of this case hinged largely on Vaikness and her team having a strong understanding of WCL § 18 and utilizing that knowledge to successfully argue the claimant did not sufficiently provide written or oral notice within the required 30-day period. Additionally, the board’s decision to reverse their amendment was significant because despite the claimant’s clear violation of WCL § 18, the board often excuses late notice and allows the case to be established. In this case, Vaikness and her team were able to showcase that the case was improperly established and highlight the claimant’s lack of a valid excuse, leading to the decision to disallow the claim.
Congratulations Stacee Vaikness. If you have a case similar to this one and are in need of assistance, please connect with our appellate team today at firstname.lastname@example.org!