Companies rely on workers’ compensation to help safeguard both their business and their employees. Unfortunately, the opportunity for personal financial tempts a surprising number of people to con the system. With her focus on workers’ compensation claims related to construction worksite accidents, Asha has become experienced at reviewing case facts, analyzing circumstances of alleged injuries, analyzing medical records and diagnostics, and rooting out insurance fraud.

• After allegedly suffering injuries in a construction site accident, a worker underwent multiple surgeries, claimed full disability, and began receiving compensation. Months later, the client informed Asha that the claimant may have misrepresented his disability and failed to disclose work activity. For over a year, surveillance was taken of the claimant working as a cab driver. We also obtained evidence showing he had changed his driver’s license to a New York State Commercial license. In addition, a passenger with whom the claimant spoke confirmed that the claimant was hired as a cab driver. Asha presented a claim under Workers’ Compensation Law 114-a. The administrative law judge found egregious conduct and fraud, handing down a permanent ban of indemnity benefits for the claimant.
• During construction of an office building in New York City, a worker reported a crush injury to his left thumb. His initial workers’ compensation claim was accepted solely for the left thumb crush injury. Later, the worker filed a claim alleging multiple injuries, and prima facie medical evidence was found for the right hip, right shoulder, neck, back, head, and post-concussive syndrome (PCS). The claimant also changed his report of how the injury happened, stating that he was struck by a metal beam and slammed into a wall, all while wearing a harness. Asha took the testimony of the claimant and doctors and, at a hearing, presented oral summations requesting disallowance of all the additional body parts. The Law Judge disallowed injuries to the neck, back, right shoulder, right hip, head, and PCS.
• A construction worker alleged an injury to multiple body parts after he fell while walking on the worksite. The employer disputed the compensability of the claim, pointing out that the worker initially told his foreman that his knee buckled while walking off-site during his lunch break. In addition, co-workers walking along with him at the time of the alleged accident did not see him fall. At trial, Asha presented testimony of three employer witnesses and cross-examined both the claimant and his physicians. The judge found that the employer was more credible, and that the worker did not suffer a work-related injury as claimed. The claimant appealed his case, and a Workers’ Compensation Board Panel affirmed the disallowance.
• Suspecting a falsified accident claim, Asha pursued a finding of fraud due to misrepresentation of the mechanism of injury, failure to disclose prior back injuries, and surveillance showing the claimant exaggerating his symptoms to doctors. She completed depositions of six medical doctors, took testimony of seven investigators and the claimant, and prepared a memorandum of law seeking a finding of fraud. In a bench decision, the judge found the claimant had committed fraud and imposed a permanent ban on all indemnity benefits. The claimant appealed, and a Workers’ Compensation Board Panel not only affirmed the judge’s finding, but also added that the claimant’s misrepresentation was egregious and imposed a mandatory penalty.