Congratulations to Jones Jones Associate Daniel Levit and his team for successfully securing the disallowance of a controverted claim on behalf of a transportation client before the New York State Workers’ Compensation Board (The Board). This win saved the client more than $50,000.
In this case, the claimant was involved in a motor vehicle accident while driving their personal vehicle during work hours to sign out for the day. The claimant sustained a fracture to the right femur and underwent open reduction internal fixation surgery. Jones Jones disputed the claim, stating that the claimant did not have authorization to drive their personal vehicle during work hours. During trial, the claimant conceded they were aware they were not supposed to be driving their personal vehicle without permission from a supervisor.
In their challenge of the claim, Daniel and his team produced a witness who noted employees in the claimant’s position must seek explicit authorization from a supervisor to use a personal vehicle. Authorization is usually granted in an emergency or if an employee is working at multiple sites in a day, neither of which applied on the day of the incident.
Through testimony from the claimant and corroboration by the witness, Daniel and the Jones Jones team were able to successfully argue the claimant put themself at risk, outside of the scope of employment. In the new decision, the judge ruled that the carrier was not responsible for medical expenses, lost time benefits or future schedule loss of use awards.
Further, because this claim developed from a covered motor vehicle accident, the carrier would only have a right to a credit against its obligation to provide benefits more than the first $50,000 paid in lieu of No-Fault. With disallowance, the carrier is not responsible for any amount.
Congratulations to Daniel and the Jones Jones team for their success on this case!
If you are in need of assistance with a workers’ compensation case, please contact our team at concierge@jonesjonesllc.com.
