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nes Jones LLC is pleased to share that Partner Christine Diana secured another successful outcome for a major airline client in the state of New Jersey.

In this case, the claimant, a flight attendant, maintained a serious shoulder injury while on the job. During the settlement proceedings, Diana negotiated for a settlement of 37.5% of shoulder injury medical costs. The claimant’s attorney argued that the case was worth more than the negotiated percentage and both parties found it necessary to get the judge’s opinion regarding the value of the case. Jones Jones argued that as the claimant had already returned to full duty work, the original negotiation was sufficient. The judge ultimately ruled in favor of Jones Jones’ client. This decision saved the client $50,000 via a settlement from the settlement demand.

In approaching this case, Diana and her team reviewed the treatment records as well as both parties’ permanency exams. The team found that the claimant did have a serious injury but had already returned to work full duty. Jones Jones was able to use that finding as a factor when negotiating the settlement. In negotiating with opposing counsel, a conference for settlement was discussed, but based on the thorough review of the treatment records and both parties’ permanency exams, Diana and her team were confident in their offer in front of the judge. The judge ultimately valued the case at the same amount Diana and her team negotiated, showcasing the team’s expertise in this space.

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

Jones Jones LLC is pleased to share that Partner Christine Diana led a successful dismissal for three cases in the state of New Jersey on behalf of a regional transportation infrastructure client.

In the three cases for this self-insured client, the claimant’s attorney argued there was a gap period between the maximum medical improvement (MMI) date and when the claimant received an accidental disability pension. Because there was a collective bargaining agreement in place, the claimant was paid a full salary rather than temporary disability benefits. As the full salary was paid, there was no payment gap and the judge ruled in the employer’s favor, dismissing the cases. This dismissal saved Jones Jones’ client from paying an additional unnecessary award.

Diana and her team approached these cases with a careful review of when the disability payment was issued, as well as what the temporary disability payments looked like. This scrutiny revealed there were no temporary disability benefits, but rather full salary payments with no gap in payment. This revelation allowed the Jones Jones team to call for a dismissal on the basis that there was no period in which the claimant was not paid. In this case, the team’s attention to detail and commitment to go above and beyond their due diligence led to a positive outcome for the client.

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

Jones Jones LLC is pleased to share that Partner Stacee Vaikness and her team secured a successful outcome before the New York State Workers’ Compensation Board (NYSWCB).

In this event, the claimant filed a case for occupational diseases involving both shoulders, both elbows, both hands, both thumbs, both index fingers, both middle fingers, both hips, both knees and both ankles. Two years after the original date of disablement, the claimant provided a permanency report from their medical provider for multiple schedule loss of use (SLU) awards totaling to just under $1 million. Jones Jones took necessary action to review and ultimately discount the credibility of both the permanency report and the medical provider who created the report.  The successful litigation of Vaikness culminated in the awards being rescinded with no need for an IME and ultimately saved our client nearly $1 million.

Upon receiving the permanency record, Vaikness and the Jones Jones team undertook an extensive medical investigation, requesting all records from the physician and cross-examining the claimant on their physical capabilities, prior injuries and treatment history, as well as cross-examining the physician twice. Taking their research a step further, the team subpoenaed treatment records from the doctor who had treated the established sites of injury during the pendency of the workers’ compensation claim but had not filed those reports with the NYSWCB. When the doctor did not initially comply with Jones Jones’ subpoena for records, the team requested Board intervention, bringing their attention to the potential size of the SLU award.

In 2020, the doctor reevaluated his 2019 opinion and, without a re-examination, modified his opinion so the award was just over $500,000, which the Law Judge awarded. Jones Jones appealed this decision, arguing that the doctor’s opinion was not credible as the claimant’s range of motion at the time of the permanency evaluation was significantly lower than what other doctors documented during earlier reports. The NYSWCB ruled in Jones Jones’ favor based on finding the physician’s opinion inherently unreliable. With this decision, the NYWCB rescinded all 18 SLU percentages and found there was no credible medical evidence in the record of permanency, meaning no money was owed to the claimant. In this case, the Jones Jones team’s tenacity, attention to detail and rigorous cross-examination process saved the client significant funds.

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

Jones Jones LLC is proud to share that Associate Kevin Moy and his team led a successful construction workers’ compensation appeal before the New York State Workers’ Compensation Board (NYSWCB). Moy’s win comes at a time of contention when there are concerns throughout the construction industry regarding workers’ compensation fraud.

Last summer, a Workers Compensation Law Judge ruled in favor of a claimant who claimed to have headaches and injuries to her neck, back and shoulders after a fall while working at a construction site. However, the construction company and insurance carrier had no records of the employee on site and denied any relationship with her. Moy and his team sought to appeal the finding that the claimant was a company employee and have the case disallowed.

The team produced lay witnesses to testify that the construction company had no records of the employee. They corroborated their position with documented evidence such as payroll records, sign-in sheets and work logs that did not include the claimant or the individuals noted in the testimony. The New York State Workers’ Compensation Board (NYSWCB) ultimately reversed the decision and disallowed the claim.

This win is significant given the current concern about workers’ compensation fraud in the construction industry. Many undocumented claimants will use the fact that they are undocumented as an excuse or explanation for why they cannot provide evidence of employment with the organization from which they are pursuing payment. Unfortunately, many judges accept this excuse although by law, it is the claimant’s burden to prove their case. In winning this appeal the team has highlighted that the NYSWCB is increasingly aware of such fraudulent actions by claimants and the lack of logic from trial Judges.

Please join us in congratulating Kevin Moy and his entire team on securing this appeal and a win in the fight against workers’ compensation fraud in construction. If you are in need of assistance with a workers’ compensation case, please contact our appellate team at clientservices@jonesjonesllc.com.