Additional Injuries Disallowed in Workers’ Compensation Case
Case Study

Additional Injuries Disallowed in Workers’ Compensation Case

January 24, 2020

A man with an accepted workers’ compensation claim for a fractured thumb cannot tack on alleged ankle, shoulder, neck, or back injuries, a judge has ruled, saying the man’s testimony about how those injuries allegedly occurred was not believable.

The judge also ruled that any workers’ compensation benefits the man received would not include payment for lost work time.

The decision, which shields the employer’s insurance carrier from a great deal of exposure by holding that the claimant may be compensated only for medical bills and only for those related to the thumb injury, is a significant victory for the defense, led by Goldberg Segalla partner Thais E. Rodriguez.

The dispute stems from a March 2019 accident in which, the 42-year-old worker alleged, a steel beam fell on his thumb while he was on a ladder. The man filed a claim for the thumb only but subsequently provided gradually more dire accounts of the accident, some of which conflicted with those of coworkers who saw what happened.

There were ever more dire medical reports, too. The day of the accident, the injured worker complained only of a cut right thumb and never mentioned falling from the ladder, and after being treated at an urgent-care center he was told he could go right back to work. By the time he went to see a doctor six months later, he was said to have much difficulty walking.

Challenging these inconsistencies under the section of New York workers’ compensation law on “disqualification for false representation,” Thais, a member of the Workers’ Compensation practice group, asked the judge to disallow the additional alleged injuries and the judge did.

As part of the Workers’ Compensation and General Liability joint-defense team, Thais is OSHA-certified, which allows her to go directly onto constructions sites to investigate accidents, inspect material and equipment, and interview witnesses at the site. And that’s exactly what she did in this case, gaining great insight into the equipment that was used and enabled her and the witnesses to explain the alleged mechanism of injury to the judge.

Led by Thais, the defense also brought in equipment as demonstrative evidence.

The disallowance of the additional sites completely stifled the claimant’s third-party general liability suit, saving the client millions of dollars.

MORE ON GOLDBERG SEGALLA’S WORKERS’ COMPENSATION PRACTICE GROUP

The mission of Goldberg Segalla’s Workers’ Compensation practice group is to achieve significant and sustainable reductions to the overall expense of each client’s workers’ compensation program. The firm’s commitment to this mission—and its success in efficient file-handling as well as long-range strategic risk-management—has earned Goldberg Segalla a national reputation for exceeding its clients’ expectations and driving positive change in the practice of workers’ compensation law.