Author: Jones Jones

Jones Jones LLC is pleased to announce that Associate Soraya Cole recently secured a favorable decision before the New York State Workers’ Compensation Board on behalf of a large self-insured public transit organization.

In this case, Soraya successfully argued the claimant had not met the burden of establishing extreme hardship. The claimant originally claimed injury to his back, consequential depression, and consequential left knee injury related to the bus he was driving hitting potholes. The case was established with an average weekly wage of $1,407.82, with Jones Jones’ client under a permanent partial disability (PPD) payment in the amount of $600.00. Pursuant to the Notice of Decision filed on 10/27/15, the claimant was classified and found to have an 80% loss of wage-earning capacity, equal to compensation for 425 weeks.  The claimant’s cap will expire on 12/19/23.

At a hearing on 08/02/23 the claimant raised extreme hardship and produced a C-35 to the Board file, wherein he listed income and expenses. Upon a thorough review  of the C-35, Soraya was able to argue that the claimant failed to demonstrate extreme hardship as the claimant had additional money in surplus even after the payment of all expenses.  Additionally, Soroya was able to uncover that the claimant receives aid from his mother and therefore this fact further aided in the lack of extreme hardship. The Workers’ Compensation Law Judge (WCLJ) adopted Soraya’s position that the claimant failed to meet the burden to demonstrate extreme hardship and so denied his application for reclassification.

Throughout this case Soraya conducted a thorough review and cross examination of all the claimant’s income and expenses. Upon completion of cross-examination of the claimant Soraya found and highlighted several inconsistencies and incorrect statements regarding the claimant’s financials. Such thorough review of the C-35, as well as Soraya’s expert summary of such inconsistencies helped showcase that the claimant was not actually suffering extreme hardship and led to the WCLJ adopting her position.

Congratulations Soraya. 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!

We are pleased to share the news that Jones Jones Associate Erica Francisco-Lau will be moving within the Jones Jones organization to join our team in New Jersey. A budding legal powerhouse, Erica will move from our no-fault department into our workers’ compensation space.

Born and raised in New Jersey, Erica holds a bachelor’s degree in psychology from Rutgers University, a juris doctorate from New England Law and is actively pursuing a master of laws in intellectual property at Cardozo School of Law. She is laser focused on emerging technology and client relationships.

“I see clients as part of the team. We’re working together to achieve the same goal,” says Erica. “Being detail-oriented means, I’ve explored every available avenue for finding the best resolution.”

Erica will report directly to Jones Jones’ Partner Christine Diana and will represent carriers and employers throughout the state of New Jersey.

“We are so excited to have Erica onboard as a New Jersey associate in workers’ compensation,” said Diana. “She fully embodies the Jones Jones spirit of collaboration and client services, and we look forward to having her energy channeled at our New Jersey clients.”

For more information on Jones Jones’ workers’ compensation practice, please visit: https://jonesjonesllc.com/workers-compensation-defense/

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!