Author: Jones Jones

Congratulations to Jones Jones Associate Sarah Vulcano on the successful disqualification of a workers’ compensation claim on behalf of an insurance carrier client in front of the New York State Workers’ Compensation Board.

In this case, the claim was initially established for injuries to the low back, left shoulder, and right ankle for an accident occurring in January 2025. The claimant received weekly benefits paid at a temporary partial disability rate between January and September 2025.

Through a strategic investigation, including the introduction of corroborating audio evidence, Jones Jones demonstrated the claimant had returned to work in March 2025, while continuing to collect workers’ compensation benefits.

At a hearing in January 2026, the claimant admitted to performing work in March 2025, consistent with records found by the carrier. It was found that the claimant lied under oath during a previous hearing regarding work status, at which awards were made. The Judge ruled the claimant violated Workers’ Compensation Law Section 114-a and found no compensable lost time after March 1, 2025. The claimant was directed to repay the carrier a total sum of $9,620 for all benefits received after March 1, 2025, and is subject to lifetime disqualification of indemnity benefits.

By securing and providing audio recording and documented evidence confirming the claimant had performed work activities, Sarah Vulcano and her team were able to show the claimant made material misrepresentations in order to secure workers’ compensation benefits. Through these findings, Jones Jones saved the carrier future benefit payments, as well as a modification of prior awards based on a higher average weekly wage.

Congratulations to Vulcano and her team for their work on this case and the successful disqualification of the claim, saving the client future payment. If you are in need of assistance with a workers’ compensation case, please contact our team at concierge@jonesjonesllc.com.

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Congratulations to the Jones Jones team on the successful appeal of a workplace injury claim resulting in more than $84,559 in savings for a carrier client in front of the New York State Workers’ Compensation Board.

The claimant filed a workplace injury claim for a left foot injury they said was the result of an accident that occurred on March 3, 2023. Prior to this claim, the individual had a significant pre-existing injury from a non-workplace-related incident which occurred about 50 years earlier. The prior injury resulted in a fusion to the left foot and staples which had since led to degenerative changes, as stated by the claimant’s doctor. At the September 16, 2024, deposition the claimant’s doctor testified that he supported a 40% causally related schedule loss of use (SLU) award. The claimant’s counsel later appealed and argued for a 60% SLU award for the left foot.

The insurance carrier’s medical consultant performed an independent medical examination (IME) and found the claimant had a 0% SLU of the left foot attributable to this claim. A thorough review of an earlier CT scan revealed no range of motion in the fused area of the claimant’s left foot prior to this accident. Additionally, the claimant’s doctor cleared the individual to return to work following a subsequent doctor’s visit on March 30, 2023, further proving the injury to be unrelated to a workplace incident and therefore non-compensable.

Jones Jones used these findings to perform a cross-examination related to the original medical records provided by the claimant’s doctors and argue against the claimant’s requested SLU award to file a rebuttal. Jones Jones’ thorough cross-examination of the records supported the workers’ compensation judge’s ruling that there was no apportionment because 0% of the impairment was caused by the work injury.

The Jones Jones team combed and examined a multitude of documents and leveraged their keen negotiation skills to secure an appeal for this case on the basis of a lack of relevant evidence of a workplace injury. Congratulations to Samantha Sokoloff and Michelle Nagesar for their well-deserved win in this case. If you are in need of assistance with a workers’ compensation case, please contact our appellate team at concierge@jonesjonesllc.com.

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Congratulations to Jones Jones Partner Stacee Vaikness on the successful disallowance of a workers’ compensation claim on behalf of a construction client in front of the New York State Workers’ Compensation Board.

In this case, the claimant filed a workplace injury claim for alleged repetitive motion injuries to the right elbow, bilateral hips and knees. At a hearing on October 14, 2025, the claimant testified their pain began approximately six years ago but could not recall where they were working at that time. The claimant also noted they did not seek medical attention until February of 2025. The claimant’s physician could not provide specific evidence as to the type of strenuous work the claimant had been doing that could have resulted in injury. In addition to a lack of evidence, the claimant did not request any changes in their job duties or take any time from work due to the alleged injuries for the past six years.

The claimant’s employer as of October 2025 stated their job duties did not require extensive physical labor such as heavy lifting, and the claimaint never reported an injury. A second recent employer stated the claimant’s work required some lifting, but that they never reported injuries or accidents while working at the company. The carriers for each employer stated that the claimant had no occupational disease or injury exposure.

After a detailed review of the materials, Vaikness argued for a full disallowance based on a lack of sufficient correlation between the claimant’s work duties and alleged injuries. The judge ultimately ruled in favor of Jones Jones’ client, finding insufficient evidence to establish a causal relationship between the claimant’s injuries and occupation. The judge found the claimant’s former employers were more credible sources in the case than the claimant’s doctor.

Congratulations to Vaikness and her team for their work on this case and successful disallowance of the claim on behalf of the construction client. If you are in need of assistance with a workers’ compensation case, please contact our team at concierge@jonesjonesllc.com.

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