Congratulations to Stacee Vaikness and the Jones Jones team on a significant victory before the New York State Supreme Court, Appellate Division, Third Judicial Department, on behalf of a large public transportation entity.
In this important appellate decision, the Third Department affirmed the denial of a workers’ compensation claim involving alleged psychological injuries arising from a January 2021 workplace incident. Of particular significance, the Court held that the employer’s filing of a First Report of Injury using an “L” code — indicating liability — did not constitute a binding acceptance of the claim and did not prevent the employer from later controverting compensability.
The claimant alleged that she developed anxiety, panic attacks, and post-traumatic stress disorder following an interaction with a customer while working. After the incident, the claimant sought medical treatment, took a leave of absence from work, and later asserted that she was unable to continue performing her job duties due to ongoing psychological symptoms.
Although the employer initially filed injury reports utilizing an “L” code, the claim was subsequently controverted, leading to litigation over both compensability and whether the employer had already effectively accepted the claim through its filings. Following litigation, the Workers’ Compensation Law Judge determined that the claimant failed to establish that the stress experienced was greater than the ordinary stress routinely encountered by similarly situated employees, and the claim was disallowed.
On appeal, Jones Jones successfully defended the Board’s decision and argued that the employer’s initial filings did not constitute a binding acceptance of liability under the Workers’ Compensation Law. The Third Department agreed, affirming both that the employer retained the right to controvert the claim despite the filing code utilized and that the claimant’s alleged psychological injuries were not sufficiently extraordinary to warrant compensation under New York law.
This decision represents an important appellate victory addressing both compensability standards for psychological injury claims and the legal effect of employer filing codes in workers’ compensation proceedings. Congratulations again to Stacee Vaikness and the entire Jones Jones team on this impressive result before one of New York’s most influential appellate courts.
