Blog

Jones Jones LLC congratulates Associate Diane C Mandleur for securing a unanimous 2024 New York State Workers’ Compensation Board Panel Decision. This decision resulted in more than $73,000 in awards for the carrier in reimbursement from the Aggregate Trust Fund (ATF) following a 2022 classification of permanent disability in New York.

This award comes following a decision that clarified a carrier’s entitlement to a statutory entitled credit, a credit provided by law for increases in employment, training, investments in property and more, under Section 15(3)(w) of the workers’ compensation law for cases with date of injury after 4/10/2017. Section 15(3)(w) addresses temporary disability benefits and labor market attachment. In this case, Jones Jones appeared at a hearing for the carrier to address an unrelated issue and Diane used the opportunity to address the credit over vigorous exception from the claimant’s attorney. The Law Judge noted the carrier’s application but denied the application for the credit.

Diane filed a request to reopen the case to address the statutory entitled credit issue. She argued carriers have an unwaivable statutory entitlement to the credit, and it can be raised at any time. In the case of Section 15(3)(w), carriers are entitled to a credit if the period of temporary partial disability is paid to a claimant after the exhaustion of 130 weeks from the date of injury, which would reduce the claimant’s entitlement under their classification award. Here, the Board agreed the credit is statutory and that the Section sets forth no provision for waiver of that right. The Board awarded the carrier a credit of 97.4 weeks calculated at present day value with interest for $73,815.70.

Diane took a persistent and vigorous approach in fighting for the client’s right to a credit in this case. The team leveraged their extensive knowledge of Section 15(3)(w) and successfully secured this decision. Tenacity and an up-to-date knowledge of recent Board decisions are key to securing wins. Congratulations Diane and the rest of the Jones Jones team. If you are in need of assistance with a workers’ compensation case, please contact our appellate team at clientservices@jonesjonesllc.com.

📄Download

Jones Jones LLC congratulates Associate Kevin Moy and his team for successfully arguing before the New York State Workers’ Compensation Board that a controverted assault claim should be disallowed.   

In this 2023 case, the claimant alleged they were assaulted by their supervisor and injured their left shoulder. The claimant denied prior injuries, but received treatment, including x-rays in 2021 diagnosing osteoarthritis. Medical examination from the claimant’s doctor and an independent medical examiner (IME) found prima facie medical evidence or sufficient medical evidence conceding causal relationship based on the claimant’s history of being assaulted. However, the claimant also denied prior injuries to the left shoulder to the IME despite 2021 treatment. Additional evidence in this case includes a video of the site, which was precluded from the record and a previous write-up against the claimant for not wearing a safety vest.  

During the trial, Moy and his team took extensive testimony from the claimant and the supervisor which contradicted one another. The claimant said the supervisor roughly grabbed the claimant’s arm whereas the supervisor testified they only lightly tapped the claimant from behind. As the testimonies devolved into a he-said-she-said situation, Moy and his team centered their argument on credibility. Moy and his team argued that their witness, the supervisor, was more credible based on inconsistencies in the claimant’s statements and there was no assault that could have resulted in injuries. The Law Judge agreed with Moy and his team and disallowed the claim. 

Moy and his team conducted thorough cross-examination of the claimant at trial, overcoming the preclusion of the video evidence and the challenge of the section 21(1) presumption that an accident took place in the course and scope of the claimant’s employment. Well done to the entire team. If you are in need of assistance with a workers’ compensation case, please contact our appellate team at concierge@jonesjonesllc.com.  

📄Download

Please join Jones Jones in congratulating Associate Kevin Moy and his team on their successful effort to disallow a controverted construction claim before the New York State Workers’ Compensation Board.   

In this case the claimant alleged they were working as a carpenter for the client’s insured when they injured their neck, back, right shoulder and both knees on the job site as a result of tripping over some pipes. The claimant also alleged they gave oral notice of the injury to the foreman on the date of the injury and had witnesses onsite. Moy and his team questioned the validity of the claim based on documented evidence the claimant worked the full day on the alleged date of accident, contrary to the claimant’s testimony that it happened in the middle of the day and that they stopped working immediately after the accident to seek medical treatment. 

During trial, Moy and his team took extensive testimony of the timeline of events on the alleged date of accident and how the alleged accident took place. Moy’s team also provided documented evidence and testimony that the claimant worked the entire day. During both examination and cross-examination, the claimant stated they were sent home from work early and drove to the hospital but provided no actual evidence or witness testimony in support of this statement. Moy and his team argued the claim should be disallowed as the claimant’s testimony and allegations were unsupported with documented evidence. The Law Judge agreed with Moy and his team and disallowed the case. On appeal, the New York State Workers’ Compensation Board also cited the claimant’s allegations were unsupported. 

Moy and his team presented compelling evidence that overcame the hurdle of the section 21(1) presumption that an accident took place in the course and scope of the claimant’s employment. The display from Moy and his team also highlighted a lack of supporting evidence from the claimant, saving the client from both financial and reputational burden in the face of a high exposure case. Well done to the entire team. If you are in need of assistance with a workers’ compensation case, please contact our appellate team at concierge@jonesjonesllc.com.  

📄Download