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Home > Archives for News

Major Win Alert: Jones Jones LLC Partner Tackles Fraud Case

08.06.2024

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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Filed Under: Blog, News

New Jersey Workers’ Compensation Fact Sheet 2024

06.27.2024

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

Filed Under: Blog, Education, News

New York Workers’ Compensation Fact Sheet 2024

06.17.2024

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

Filed Under: Blog, Education, News

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

01.26.2024

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.

Filed Under: Blog, Education, News

Case Closed: Recent Wins for Jones Jones Clients in NY and NJ

07.03.2023

We are all familiar with the dread that accompanies an open case. Countless hours and dollars are spent going back and forth with the opposing party, not to mention the stress and headache of ongoing litigation. Focused on resolving this dread, and the related costs, Jones Jones LLC attorneys across New York and New Jersey take a different approach, applying a settlement-first mindset to all cases and handling of workers’ compensation claims. Whether the venue was in live court in New Jersey, virtual hearings in New York or around a conference table in downtown Manhattan — our attorneys’ mission to close claims resulted in several major wins in June.

New Jersey Wins:

Partner Christine Diana and Associate Kristina Jones settled nine workers’ comp claims in a single morning during a recent court appearance. They capitalized on our firm’s unique approach once it was clear all parties were physically present under tenuous conditions. A quick look at some of those wins include:
• A 55-year-old safety officer with multiple claims had already undergone bilateral bicep tendon repair. Rather than leave this claim open to high-cost medical treatment for many years, Christine Diana strategically negotiated a successful settlement in person.
• Kristina Jones used live testimony from an injured worker who had suffered an occupational disease to bilateral ankles with bilateral ankle replacement to successfully close a case with a Section 20. “The ability to take the gentleman’s testimony and understand his thought process made it easier for me to assess his settlement needs and close this case with a full and final settlement,” she said.

Success in New York:

In New York, Partners Rosanna Shamash, Ian Leaderman, and Samantha Sharpe held a settlement conference with a self-insured employer. The settlement conference culminated in dozens of full and final Section 32 settlements. They strategized with the client directly, sought immediate authority to settle claims and conferenced with injured worker attorneys in the moment. “It was a hugely satisfying day resulting in many settlements, including closure of claims that have been open for several years,” said Samantha.

Managing Partner Sarah Thomas has made it a mission to instill a settlement approach to claims for the last decade. “These successes are a culmination of the continued cultural shift our firm has taken seriously in the settlement space within workers’ comp. We are constantly available to push the envelope – to ask the hard questions – and dig deeper as to why a workers’ comp claim may not be settling. We are always pushing a claim towards a settlement where possible. And when faced with a challenge, our team attacks it head on. Nothing stops a Jones Jones attorney,” she said.

Proud of the firm’s 100-year history and ability to constantly pivot and stay ahead of all workers’ compensation changes and nuances, Executive Partner Matthew Jones explained the settlement focus is part of the firm’s intentional culture, “We talk about settlement approach, best practices and share each other’s wins during our attorney meetings. Learning from one another about best practices for obtaining a settlement using an out-of-the-box approach for a client is exciting. It culminates in a finality that is best for the client, best for the injured worker and rewarding for those of us trying to do our best for our client.”

If you are interested in seeing how a settlement conference can impact your caseload, or if you would like to discuss a settlement strategy-contact settlements@jonesjonesllc.com or sthomas@jonesjonesllc.com. The Jones Jones LLC team is excited to navigate you and your team through the settlements of NY and NJ!

Filed Under: Blog, Education, News

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