Jones Jones LLC Partner Stacee Vaikness and her team have secured a third department win in a recent Workers’ Compensation Law § 114-a fraud case appealed from the New York State Workers’ Compensation Board (NYSWCB).
In this case, a workers compensation claim was made in 2016 alleging the plaintiff experienced work-related injuries due to repetitive use of his right shoulder and both knees. After a permanency evaluation was performed, a hearing to address the claimant’s preexisting injuries and conditions was requested by the self-insured employer.
In the August 2021 hearing, the employer provided surveillance video showing the claimant misrepresented his physical condition and failed to report work activity he engaged in following retirement. A hearing was held to address the 114-a violation, with testimony from an investigator retained by the employer and the claimant. The Workers’ Compensation Law Judge found the claimant deliberately misrepresented his physical condition during an independent medical exam and the Workers’ Compensation Board affirmed the decision, finding the claimant did violate Workers’ Compensation Law § 114-a. The decision implements both mandatory and discretionary disqualifications, which includes disqualification of all future indemnity payments.
Vaikness and her team worked extensively to prove the claimant’s misrepresentations and omissions were fraudulent under WCL 114-a. Overall, the affirmation Vaikness and her team secured will prevent the claimant from ever receiving additional indemnity benefits, including SLU awards that would have amounted to approximately $300,000.00.
Well done to Stacee Vaikness and her entire team on securing this appeal. If you are in need of assistance with a workers’ compensation case, please contact our appellate team at clientservices@jonesjonesllc.com.