Author: Jones Jones

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

Jones Jones LLC Partner Rosanna Shamash won a Third Department decision in Juanita Jones v. New York City Transit Authority (https://decisions.courts.state.ny.us/ad3/Decisions/2022/534984.pdf). The underlying facts of this decision begin with a Law Judge’s determination that the claimant violated fraud Section 114-a by failing to disclose certain work activities.  Ultimately, the Law Judge sanctioned both mandatory and discretionary penalties; meaning that not only would the claimant have to pay money back, but also that she would no longer be qualified to receive any future indemnity payments arising from this claim. Upon appeal of this decision, the NYS Workers’ Compensation Board noted that the RB-89 portion of the claimant’s appeal was not fully completed and therefore the appeal was completely denied.  Partner Shamash was able to have this finding upheld before the Third Department despite the claimant raising a newly enacted law, WCL 23-a(1).  WCL 23-a(1) states, that “a mistake, omission, defect and/or other irregularity in a {form RB-89} accompanying an application for administrative review …shall not be ground for denial of said application.” Partner Shamash was able to skillfully highlight to the Court that the merits of the case support the finding of fraud and that WCL 23-a(1) does not apply to this matter as the legislation came into effect after the filing of the incomplete RB-89 by the claimant.

Congratulations to Partner Shamash for a great win!

Jones Jones LLC Attorney Katie Caracappa presented successful arguments before the Third Department Court in New York State and secured a win for the self-insured employer in the decision of Molander v. New York City Transit Authority (534520.pdf (state.ny.us)).  Based on Attorney Caracappa’s arguments, the Court found that the claimant’s wage loss was unrelated to his underlying Worker’s Compensation claim; ultimately saving the self-insured employer $110,000 in indemnity awards.

The case had previously been established for obstructive airway disease, gastroesophageal reflux disease, upper respiratory disease, and sleep apnea. The claimant  had not lost any time from work due these conditions since 2015, but thereafter maintained that he had stopped working in February 2020 due to his respiratory issues associated with his case.  The claimant took the position that his lung condition had deteriorated and he was no longer able to work.  However,  through litigation the Jones Jones LLC team was able to demonstrate that the reason the claimant had actually stopped working was unrelated to his underlying Worker’s Compensation claim. The claimant had been involved with some legal troubles out of state and disciplinary proceedings with the employer resulted in his work stoppage.  After reviewing the brief that Attorney Caracappa prepared,  The Third Department agreed that the claimant was not credible and found the reason that the claimant stopped working was unrelated to the underlying claim.

We are proud of another great appellate win from the Jones Jones team.  Congratulations Katie Carcapppa! Contact clientservices@jonesjonesllc.com should you or your team have any questions or need to connect with an attorney on appellate process.