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Key Takeaways from Partner Kathleen Ginnane’s Panel Discussion at the New Jersey Self Insurers Association Conference

05.16.2022

Jones Jones LLC Partner Kathleen (Kassy) Ginnane provided her expert opinion as part of a panel discussion at the New Jersey Self Insurer’s Association (NJSIA) Conference May 13th, 2022 in Atlantic City, New Jersey. Kassy provided the New York perspective as part of a panel discussion entitled, “What Really Happens when you Presume: Presumption Laws and their Impact”

Kassy is often asked to provide her legal analysis to clients and conferences alike on a variety of workers’ compensation issues. At Jones Jones LLC she is a Supervising Partner, meaning she leads a team of attorneys to tailor their practice to the needs of our clients. Kassy counsels clients and attorneys on the intricacies of workers’ compensation and insurance defense law. Kassy began her legal career at Jones Jones LLC as an associate, handling thousands of New York State claims from inception through closure. As a Supervising Partner, Kassy has spearheaded many successful settlement initiatives, often hosting bulk settlement days at our firm’s office. Kassy enjoys educating employer and carrier clients on various aspects of worker’s compensation law, most recently on issues including electronic claims filing and reporting, settlement strategies, and updates to the New York State Workers’ Compensation Board internal processes. Kassy earned her LL.M. in International Legal Studies from New York University School of Law, and her LL.B. from Queen’s University, Belfast, Northern Ireland.

The May 13, 2022 panel discussion at the NJSIA was a lively one! Kathleen educated the attendees on the current state of presumptions in the NYS Workers’ Compensation system; specifically as it relates to World Trade Center and Covid-19 claims. Kassy also provided an insight in to the possible future of presumptions – with a particular focus on what the legal future might hold for Covid-19 claims.

Kassy is happy to discuss presumptions and how they affect your claims in New York State—reach out to the firm today at clientservices@jonesjonesllc.com to schedule a time and talk tailored for you and your claims team!

Filed Under: Blog

Jones Jones LLC Back to Basics: RFA-2 Requirements

05.07.2022

The RFA-2 is a New York State Workers’ Compensation Board form. Specifically, it is a “Request For Further Action” by the carrier or employer and can be found here. This form would be filed by the carrier or employer when a need for a hearing arises.  Recently, the NYS Workers’ Compensation Board has been taking a closer look at RFA-2 forms to ensure that they are properly and fully completed prior to granting a request for a hearing.

How can you make sure that your RFA-2 is proper and complete?

  • The RFA-2 must be filled out in its entirety. If there are missing fields, the Board will reject the entire RFA-2.
  • On the ‘Compensation/Medical Issues/Other’ tab, the person filing the form must check off the appropriate box and fill in the associated fields. In addition, the person filing must fill in the box labeled: **Document reference information (date, name / title, form ID).
  • On the ‘Sign’ tab, the person filing must certify that they have either discussed the issue with the opposing party, or attempted to contact the opposing party. These fields must be completely filled out, or the Board will reject the RFA-2. Further, the Board is now requesting proof that the opposing party was contacted. This requires the person filing the RFA-2 to email or call opposing counsel, and properly document same. Proof of contact should be sent to defense counsel in preparation for hearing.
  • The person filing the RFA-2 should monitor the Board file for the ERFA-2.1 (Board response to the RFA-2) and ensure that the Board has accepted the RFA-2 and taken the actions requested (scheduling a hearing, issuing an EC-81.7, etc.).

The attorneys at Jones Jones LLC are  always happy to assist with the RFA-2 process.  We are available to personally file the RFA-2 document as well as to contact the claimant’s attorney to advise them of the RFA-2 issues.

Contact us today at clientservices@jonesjonesllc.com for assistance today!

Filed Under: Blog Tagged With: workers comp

News Bulletin: NYS Workers’ Compensation Benefit Increase

05.01.2022

On April 20, 2022, the New York State Workers’ Compensation Board announced that the maximum weekly benefit rate for workers’ compensation claimants is $1,125.46 for injuries sustained from July 1, 2022 through July 30, 2023.  See the Board’s announcement here.

The attorneys of Jones Jones LLC are experienced litigators and defense specialists and are eager to work with you and your team in order to mitigate the ever increasing cost of claims.

Reach out to a Jones Jones LLC partner today for guidance in developing a solid strategy to make a difference on your case load at clientservices@jonesjonesllc.com.

Filed Under: Blog Tagged With: workers comp

Jones Jones LLC Major Win Alert: Successful Litigation on a Jurisdictional Issue

03.23.2022

We are excited to announce a major win secured by Jones Jones LLC Attorney Ian Leaderman. This win highlights:

  • The jurisdictional complexities that may arise while representing national or worldwide employer entities;
  • The success that can come with a detailed review of the facts surrounding a claimant’s contacts with New York State versus their home state;
  • The need to review a claim for an aggressive defense, despite possible filing issues with pre-hearing conference forms.

Attorney Ian Leaderman recently successfully litigated a claim before the New York State Workers’ Compensation Board for an airline client on the issue of proper state jurisdiction. The flight attendant claimant sustained injury to her neck, left shoulder, back and bilateral wrists as she pushed a drink cart during a flight between Greece and JFK. The claimant was a Georgia state resident at the time of injury and immediately begun to start treating in her home state. Thereafter, a claim was initiated with the Georgia State Board of Workers’ Compensation on September 6, 2019, just two days after the subject accident. Several “WC-2, Notice of Payment” forms were filed by the Georgia Board documenting indemnity payments made to the claimant. Eventually, the claimant’s Georgia doctors found that the claimant had reached maximum medical improvement and was 0% disabled.

Six months after the date of accident, and after receiving Georgia workers’ compensation benefits, the claimant’s New York attorney filed an initial notice of claim with the New York State Workers’ Compensation Board. In April 2021, a hearing was scheduled and evidence regarding the Georgia claim was submitted for review by the New York State Law Judge. Ultimately, Attorney Leaderman argued that there were simply insufficient ties to New York State to establish a New York claim; advising the Law Judge that the record demonstrated that the claimant resided in Georgia and chose to pursue all medical treatment in Georgia. Further, had the need for litigation, testimony, etc. arose, particularly with regard to any medical disputes, the witnesses, including the claimant’s physicians, all resided in Georgia as well.

The New York State Law Judge issued a Reserved Decision finding in favor of all of Attorney Leaderman’s points, concluding that there was a lack of sufficient contacts to established a New York State claim. The claimant’s attorney appealed this decision, heavily relying on the fact that the carrier for the airline did not timely file a pre-hearing conference form outlining the defense of jurisdiction. On appeal, Attorney Leaderman argued that the issue of jurisdiction can be raised at any stage of a workers’ compensation claim . The Board Panel agreed, and upon review, held that the carrier’s failure to file a pre-hearing conference statement is not a waiver of the issue of subject matter jurisdiction (see Hermann Transportation, 2018 NY Wrk Comp G1069461), while also noting that the New York Law Judge properly found that there is no subject matter jurisdiction in New York. The Board upheld the disallowance of the claim. Attorney Leaderman’s excellent litigation of this claim allowed for the case to remain closed with the finding of a 0% disability at maximum medical improvement.

Jones Jones LLC attorneys are ready to navigate you and your team through the complexities of jurisdictional defenses. Our attorneys will apply the necessary detailed review and aggressive approach to ensure success.

Contact us today at clientservices@jonesjonesllc.com to connect with an attorney today!

Filed Under: Blog

Major Win Alert: Jones Jones Wins NYS Appellate Reversal of $280k SLU Award

03.23.2022

Attorney Katherine Caracappa secured a major win for a Jones Jones LLC client before the New York State Appellate Division- Third Department on March 10, 2022.

The case involved a transportation worker with an established occupational disease claim for injury to the elbows, ankles, knees, and wrists. The claimant’s treating doctor submitted medical evidence finding that the claimant was permanently disabled and had reached maximum medical improvement. The doctor ultimately found the claimant presented with 25% schedule loss of use of both hands, 20% schedule loss of use of both legs, and 20% schedule loss of use of both ankles.

While the self-insured employer was precluded from obtaining an independent medical examination on schedule loss of use, the attorneys at Jones Jones LLC did cross-examine the claimant’s treating provider and attacked his opinion on schedule loss of use. During litigation, the following arguments were highlighted:

  • That the issue of permanency was premature due to the fact that the claimant had not yet finished treatment;
  • The doctor who gave the schedule loss of use opinion failed to review all medical records and was therefore lacking credibility;
  • The schedule loss of use determination by the doctor did not conform with the guidelines on permanency; and
  • The findings of permanency did not correlate with the claimant’s complaints of pain and physical limitations.

It was argued that awarding approximately a $280,000 schedule loss of use award for a case that concluded with no surgeries and was ultimately a soft-tissue injury only was outside the realm of appropriate assessment of the permanency guidelines as set forward by the Board itself.

The Law Judge found in favor of the claimant’s treating provider and the Board Panel ultimately upheld the doctor’s conclusions on schedule loss of use.Both the Law Judge and the Board appeared to make their decisions based on the lack of independent medical examination and thus did not review the arguments raised in response to the schedule loss of use finding.

Attorney Caracappa drafted an aggressive Appellant Brief attacking the fact that the Board did not entertain any of the issues and arguments raised on behalf of the self-insured employer during the course of litigation. The Third Department was compelled by Attorney Caracappa’s arguments and found, “The Board’s failure to specifically address the claims raised by the employer deprived the employer…of the opportunity to have the Board consider the merits of …issues that were properly preserved and precludes any meaningful review by this Court,” (See decision here).

The Third Department agreed with Attorney Caracappa’s arguments that the Board erred in not addressing the issues raised on our application for review of the Board’s decision and as such the Third Department rescinded the finding of schedule loss of use and sent the case back before the Board for resolution of the arguments raised by Jones Jones LLC.

Jones Jones LLC takes great pride in our Appellate Appeal department. We understand the detail and precision needed to execute a winning appeal to the higher courts. In addition, the litigation and review of claims involving high schedule loss of use awards also requires extra review and intricate knowledge of the permanency guidelines. Jones Jones LLC is very happy to announce this Appellate Division win that will assist other self-insured employers, carriers, and third-party administrators in their litigation on costly schedule loss of use awards.

Contact us today at clientservices@jonesjonesllc.com to discuss litigation planning on permanency cases and any questions you and team may have on the appeals process.

Filed Under: Blog

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