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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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New Jersey Workers’ Compensation Fact Sheet 2024

Jones Jones LLC knows that workers’ compensation claims can be complex. In an industry bogged down by forms, statutes, and filings, we aim for efficiency in all we do.  To that end, we wanted to make sure that you, our clients, had access to the most up-to-date pertinent information regarding New Jersey workers’ compensation.

Are you an examiner that is looking for a quick reference? Are you a risk manager overseeing New Jersey claims? Are you an employer addressing your first workers’ compensation case? Please look no further than the Jones Jones LLC New Jersey Workers’ Compensation Fact Sheet.

New Jersey Workers Compensation Fact Sheet 2024

New York Workers’ Compensation Fact Sheet 2024

Jones Jones LLC knows that workers’ compensation claims can be complex. In an industry bogged down by forms, statutes, and filings, we aim for efficiency in all we do.  To that end, we wanted to make sure that you, our clients, had access to the most up-to-date pertinent information regarding New York workers’ compensation.

Are you an examiner that is looking for a quick reference? Are you a risk manager overseeing New York claims? Are you an employer addressing your first workers’ compensation case? Please look no further than the Jones Jones LLC New York Workers’ Compensation Fact Sheet.

New York Workers Compensation Fact Sheet v2

Workers’ Compensation Board to Index Every Complete Case by Mid-2024

At the end of 2023 the New York State Workers’ Compensation Board (the Board) announced their plan to begin indexing every complete workers’ compensation case by mid-2024. We are writing today to inform you that process will begin shortly.

 

What does this mean for carriers? Every case with an Employee Claim (Form C-3) or First Report of Injury (FROI) and a medical report of treatment will be indexed by the Board. Additionally, following indexing, any denial of the claim must be filed with the Board within 25 days of the date of indexing or defenses listed in Workers’ Compensation Law Section 25(2)(b) will be barred.

 

Due to this indexing, we foresee an increase in workload for all carriers, third-party administrators and self-insurers due to a potential increase in claim denials. As the process moves forward, we have the following recommendations for our partners:

 

  • All parties should ensure their adjusters are prepared for the possible influx of work. This means the examiners will need to review their cases and be timely in responding to each case to ensure the preservation of their right to deny a claim if proper and necessary.

 

  • If there is no medical report in the file, we do not expect the case to be indexed.

 

  • However, if there is a medical report in the case all parties need to ensure the examiner has had an opportunity to fully investigate the case and to have come to a determination as to whether to accept or deny it.

 

  • Examiners should contact their defense counsel to collaborate on making final determinations.

 

  • Carriers, third-party administrators, and self-insured employers should also attempt to gauge how many unindexed claims they have so they can determine if they need to dedicate a specific task force or team to this in the coming months.

 

For more information on this announcement or to collaborate on case denial or acceptance, please contact clientservices@jonesjonesllc.com.

New IME Resource Available

At Jones Jones LLC, we understand the importance of working with a good independent medical examiner (IME). A qualified, reputable IME can help strengthen your case, and working with the wrong IME can lead to frustrating decisions and appeals. This is why we are pleased to announce the official Jones Jones list of preferred IME doctors for New York State.

 

This list includes who we believe are currently the best IME doctors in New York State. As Jones Jones serves the entirety of New York state, from Manhattan to the upstate region and everything in between, we wanted to ensure we offered an exhaustive list of IME doctors for all areas of the state as well.

 

From orthopedists and cardiologists to psychiatrists and psychologists, our attorneys spent the last several months reviewing and considering various factors to determine the best IME doctors with whom we work. We reviewed how well the doctors testified, how well their reports were written, their overall communication skills and more. Our panel of attorneys then held roundtable discussions to develop this fair and comprehensive list.

 

For more information on Jones Jones’ resources for clients and colleagues, and to obtain the list please contact sthomas@jonesjonesllc.com.