Author: Jones Jones

Jones Jones LLC is pleased to announce that Partner Rose Shamash recently secured a favorable decision before the New York State Workers’ Compensation Board.

In this case, Rose successfully argued for the law judge’s original decision that the claimant had a 30% schedule loss of use of the left arm to be overturned. Upon the announcement of the original finding, Rose and her team filed for an administrative review of the decision with the New York State Workers’ Compensation Board. Rosanna argued that the original decision was an error as neither medical opinion in this case were credible or in accordance with the Board’s Impairment Guidelines and the Board ruled in her favor.

With this appeal, Rose overturned approximately $65,000 in schedule loss of use awards. In the New York State Workers’ Compensation Board’s new findings, the claimant was found to have a 10% schedule loss of use of the left arm. The 10% disability in this finding exceeds the schedule loss of use as the claimant had already been paid for 31.2 weeks of benefits and therefore nothing moved to the claimant.

The success of this case hinged on Rose’s in-depth understanding of the Board’s Impairment Guidelines. While both doctors found the claimant to have a 30% schedule loss of use in the left arm, Rose understood what evidence and explanation is necessary to fully meet the Board’s Impairment Guidelines and helped showcase that the doctors’ testimonies were not credible, leading to the overturning of the original decision.

Congratulations Rose. If you have a case similar to this one and are in need of assistance, please connect with our appellate team today at clientservices@jonesjonesllc.com!

Jones Jones LLC is pleased to announce that Partner Samantha Sharpe recently secured a favorable decision before the New York State Workers’ Compensation Board on behalf of a self-insured big box store.

Samantha successfully secured a disallowance of the workers’ compensation (WC) case following an initial Reserved Decision by the Law Judge. The plaintiff originally signed Form C-3 (Employee Claim) contending injuries to the back, left hip and right hip while lifting heavy materials at work. Both the plaintiff’s doctor and the independent medical examiner (IME) found a causal relationship between the back injury and the work incident. Samantha argued that the case must be disallowed as the treating doctor’s testimony was not credible to support a causally related work accident or occupational disease.

Throughout this case Samantha conducted a thorough review and questioning of all witnesses on what was alleged on the C-3 as the mechanism of injury (i.e., accident vs. repetitive stress injury). Upon completion of the review and questioning, Samantha directed cross-examination of the claimant and doctors to the mechanism of injury. In this case both the treating doctor and IME conceded causal relationship, however it is important to note that a case should not always be established when an IME concedes causal relationship. In this instance, the IME’s concession was based on an inaccurate description of how the injury occurred reported to him by the claimant. The thorough questioning and direction of the cross-examination helped showcase that the doctor’s testimony was not credible and led to the disallowance of the case.

Congratulations Samantha. If you have a case similar to this claim and are in need of assistance, please connect with our appellate team today at clientservices@jonesjonesllc.com!

Jones Jones LLC is pleased to announce that Partner Samantha Sharpe recently secured a favorable decision before the New York State Workers’ Compensation Board.

In the case of an injured worker versus a home health care company, Samantha successfully argued for the workers’ compensation (WC) case to be disallowed by the Law Judge after finding the claimant not credible. In this case it was found that the claimant’s WC claim appeared to be an afterthought after the claimant’s disability ran out and they were denied unemployment.

The success of this case hinged largely on effective witness preparation and comprehensive document review, demonstrating the critical importance of both in a claim. Samantha noted, “[The witness] had really helpful information including documents relating to claimant’s notice of this injury and filing for disability benefits and unemployment.” These documents, paired with the witness testimony allowed Samantha to rebut the claimant’s testimony in a seamless way that led the Law Judge to disallow the claim. While the claimant’s counsel appealed, the New York State Workers’ Compensation Board affirmed the disallowance finding the claim for WC benefits appeared to be an afterthought when all other resources had been exhausted.

Congratulations Samantha. If you have a case similar to this one and are in need of assistance, please connect with our team today at clientservices@jonesjonesllc.com!

In New York City Transit Authority v. American Transit Insurance Company, 2022 NY Slip Op 07508 (App. Div., 1^st Dept. 2022), Jones Jones LLC Partner Jackie Mancino was successful in obtaining an Appellate Division decision reversing the lower court’s order that would have prevented Jones Jones LLC client, The New York City Transit Authority, from recovering a $25,000 award in their favor. Jones Jones LLC’s handling of this matter began with the filing of a Loss Transfer claim in which the Transit Authority sought reimbursement for Workers’ Compensation benefits paid in lieu of No-Fault benefits arising from an employee’s injuries suffered in a motor vehicle accident. Following arbitration of the claim, Jones Jones LLC succeeded in securing an award of $25,000 for our client. However, the respondent insurer failed to issue payment.

In order to enforce the arbitration award, Partner Mancino filed a petition seeking to confirm the award and enter judgment for the outstanding amount. However, the lower court dismissed the petition based on a misapplication of the statute of limitations. Specifically, the lower court failed to properly apply Executive Order 202.8, which was signed by Governor Andrew Cuomo on March 20, 2020 in response to the Covid-19 public health crisis and included a provision tolling the specific time limit for the commencement, filing, or service of any legal action from said date through November 3, 2020, which was a span of 228 days. The lower court erroneously applied the toll as if it were merely a 228 day extension of the statute of limitations, thus finding that the statute of limitations expired 228 days after the toll was lifted on November 4, 2020, or on June 21, 2021. On appeal, Partner Mancino correctly argued that a toll is distinguishable from a mere extension because a toll essentially presses the pause button on the clock counting down the time within which a particular action must be taken. Thus, where the time period for taking action is tolled, the clock, which was paused by the toll, simply begins to run again when the toll is lifted. As such, in the case at bar, there were 350 days remaining on the applicable statute of limitations when the toll went into effect on March 20, 2020. As such, when the toll was lifted on November 4, 2020, there remained 350 days until the statute of limitations expired as opposed to 228 days.

The First Department agreed with Partner Mancino’s position on the issue, reversed the lower court’s decision and confirmed the arbitration award, which will allow Jones Jones LLC to pursue the full amount originally sought by our client.  Contact the Jones Jones LLC Loss Transfer team at clientservices@jonesjonesllc.com