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Jones Jones LLC Educates on Continued RICO Fraud Cases with All-Staff Webinar

In October 2024, the New Jersey and Manhattan offices of Jones Jones LLC came together virtually for an informative webinar on the recent rise in cases being investigated by the Racketeer Influenced and Corrupt Organizations Act (RICO) throughout New York. This webinar is one of many educational sessions and trainings Jones Jones offers staff and clients alike to remain at the forefront of litigation trends and changes.

In these cases, an insurer is claiming construction workers, local lawyers, doctors and other vendors have collaborated to stage accidents in an alleged scheme to commit insurance fraud. These instances of fraud are on the rise and have caused costly claims for insurers as well as increased insurance premiums for insureds.

Jones Jones has recently handled a number of workers’ compensation cases tied to the RICO cases, including a case that Partner Katherine Caracappa outlines in a recent Major Win Alert blog. Jones Jones remains at the forefront of litigation claims related to RICO cases and continues to win these cases as we use in-depth knowledge of workers’ compensation law and thorough research tactics to address these cases. Meetings and trainings such as the RICO webinar help Jones Jones staff stay aware of the cases, as well as informing all attorneys on tactics to continue to secure positive outcomes.

The construction team, made up of Supervising Partner Rosanna Shamash, Partner Dana Sabghir and Partner Katherine Caracappa, presented to the entire Jones Jones staff during this lunchtime webinar.

Jones Jones LLC offers educational meetings and informational trainings, such as the RICO webinar to clients to help them remain at the forefront of trending industry issues and mitigate risk to their business. If you are interested in hosting Jones Jones for a training session, please contact our appellate team at clientservices@jonesjonesllc.com.

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Major Win Alert: Jones Jones LLC Partner Breaks Claimant’s Credibility, Secures Disallowance

Congratulations to Jones Jones LLC Partner Katherine Caracappa for securing a disallowance before the New York State Workers’ Compensation Board. Caracappa and her team found the claimant lacked credibility due to a number of inconsistencies between their testimony and C-3 form, or employee claim form.

In this case the claimant stated they were conducting work to build a deck for their employer when a heavy object fell and injured them. On their C-3 the claimant stated they gave notice to an alleged witness on the date of the incident and noted they were not sure if anyone witnessed the accident. During testimony, the claimant stated they had not spoken to the alleged witness, and thought the witness would have heard about the incident through word of mouth or by reviewing camera footage. The claimant also stated in their testimony that the accident happened in front of a lot of people, but no one helped them up. The witness testified they had not spoken to the claimant about the incident and heard about it from another worker a month after the claimant stopped working.

During cross-examination, Caracappa and her team pushed the claimant on their inconsistencies between the C-3 and their testimony. The claimant could not explain these inconsistencies and their testimony fell apart. Additionally, the claimant failed to list any witnesses to the accident on their C-3 but named multiple people during their testimony, creating more inconsistencies. Caracappa and her team made Summations on behalf of the client due to the number of inconsistencies and inappropriate nature of the claimant naming witnesses in their testimony that were not listed in their C-3. The Law Judge agreed to the Summations and based on the claimant’s ultimate statement that they did not report the incident to their superior, the Law Judge found the claimant was not credible and disallowed the claim.

Caracappa and her team showcased exhaustive research skills in finding the many inconsistencies between testimonies and C-3. The team also exemplified strong cross-examination skills. Congratulations to Caracappa and her team on this positive outcome. If you are in need of assistance with a workers’ compensation case, please contact our team at clientservices@jonesjonesllc.com.

Major Win Alert: Jones Jones Secures Dismissal for International Airline

Jones Jones LLC congratulates Associate Erica Francisco-Lau and her team on securing an out-of-state dismissal on behalf of an international airline in New Jersey. This dismissal comes amid a rise in filings of similar Pennsylvania workers’ compensation cases in the state of New Jersey.

In this case, the medical provider of a Pennsylvania worker for a major airline filed a claim to recover bills for surgery and appointments totaling over $61,000. The worker was injured in Pennsylvania while working as a baggage handler since 2012. As a New Jersey resident, the petitioner received some medical treatment in New Jersey where the claim was filed. In a trend we have seen applied in similar out-of-state cases, the claim was filed in New Jersey because the reasonable and customary standard is considerably higher than the Pennsylvania fee schedule prescribes.

After working closely with the airline, Erica and her team confirmed that the petitioner was hired in Pennsylvania and never worked for the airline in New Jersey. The team filed a motion to dismiss the claim in court on the basis that the medical provider’s counsel could not prove that New Jersey had any jurisdiction over this Pennsylvania worker’s compensation claim. The judge granted the motion and dismissed the case with prejudice, forcing the medical provider to consult the Pennsylvania’s Workers’ Compensation Board to dispute the bill amount paid.

Erica and her team produced an incredible outcome for our client, securing this dismissal thanks to her team’s keen understanding of workers’ compensation law, particularly across state lines. Please join us in congratulating Erica and her team. If you are in need of assistance with a workers’ compensation case, please contact our appellate team at clientservices@jonesjonesllc.com .

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Major Win Alert: Jones Jones Associate Wins Order of Dismissal

Congratulations to Jones Jones LLC Associate Erica Francisco-Lau and her team for leading a successful Order of Dismissal in front of the Jersey City Workers’ Compensation Court.

 

In this case, the medical provider claim in question originated in New York, with the claim stating the petitioner was injured in New York and works for a New York employer. The petitioner is a New Jersey resident and received medical treatment associated with her claim in New Jersey. As the usual, reasonable, and customary standard is higher in New Jersey than the New York fee schedule, the applicant filed their claim in New Jersey.

 

Francisco-Lau filed a response to the New Jersey medical provider claim denying jurisdiction as the petitioner works in New York, her accident occurred in New York, and she had a New York claim. The team further argued jurisdiction could not be established on the sole basis of residency. The motion to dismiss was opposed by the petitioner’s representation because the petitioner claimed she was hired remotely while in New Jersey.

 

The petitioner was unable to present a copy of her hiring documents to confirm where she was hired, and the petitioner stated she could not recall where she was hired and only worked in New York. Opposing counsel confirmed the petitioner would consent to the Order for Dismissal with prejudice to be entered by the Court. The Court filed the executed Order of Dismissal with prejudice signed by the judge earlier this year.

 

Please join us in congratulating Francisco-Lau and the entire Jones Jones LLC team. If you are in need of assistance with a workers’ compensation case, please contact our team at clientservices@jonesjonesllc.com.

 

Major Win Alert: Jones Jones LLC Partner Tackles Fraud Case

Congratulations to Jones Jones LLC Partner Katherine Caracappa and her all-female construction defense team for securing a disallowance on a recent fraud case before the New York State Workers’ Compensation Board. Fraud and construction are being scrutinized by both the Board, as well as other state and federal entities due to the recent Racketeer Influenced and Corrupt Organizations Act (RICO) cases making headlines throughout New York.

 

In the case at hand, the plaintiff originally reported slipping on debris causing injury while working at a construction site. A similar case was also filed by another plaintiff with very similar fact patterns and medical details.   Both plaintiffs claimed to be injured on the same day, at the same jobsite and appeared to be injured in the same manner. The two individuals initially went to the same hospital, were treated by the same physicians, were represented by the same law firm and switched to another law firm together. In addition to the questionable coincidences, the original claimant reported contradictory medical histories regarding the nature of their injuries and failed to mention the supposed witness (the other plaintiff) on his employee claim (C-3) form.

 

During cross-examination, Caracappa and her team pushed the claimant on conflicting testimonies including differing mechanisms of injuries that was recounted in a variety of documents- both legal in nature and medical.  Additionally, Caracappa was able to bring to the Law Judge’s attention the plaintiff’s failure to mention any witnesses -including the other alleged plaintiff- and the interesting question as to how both plaintiffs come to have the same legal representation.

 

The undertones of the recent RICO cases impacting the New York construction industry prompted the law judge’s decision to find fraud on this case. The law judge noted similar fact patterns in both cases, with neither acknowledging each other in their own cases. Based on the RICO concerns throughout the case, the law judge also noted it would be referred for criminal prosecution.

 

“Katie and her team exemplified an aggressive and thorough strategy that resulted in this outcome,” said Jones Jones Managing Partner Sarah Thomas. “Construction fraud in New York is a reality, as can be seen with the recent RICO cases. Law judges are taking notice and one key to success with these types of cases is looking for inconsistencies as Katie and her team did in this situation. We are proud the contributions these talented attorneys made in addressing a statewide problem that impacts real-world inflationary items like rising real estate costs, insurance premiums and more.”

 

If you are in need of assistance with a workers’ compensation case, please contact our appellate team at clientservices@jonesjonesllc.com.

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