What’s Hot in Workers’ Comp, Vol. 25, No. 10, October 2021

What's Hot in Workers' Comp - News and Results*

NEWS

Hear Jeff Rapattoni (Mount Laurel), a shareholder in our Casualty Department, speak at this year’s National Insurance Crime Bureau Workers’ Compensation Fraud Conference. In “Telemedicine Driven Claims,” Jeff will discuss the recent surge in fraudulent telemedicine-driven claims. He will provide insight into the regulation and history of these claims, as well as discuss ways in which insurers might be exploited and how to investigate these claims. For more information and to register for the webinar, visit https://nicblearning.wixsite.com/website
 

RESULTS*

Ross Carrozza (Scranton) won a black lung decision on appeal. The case involved a coalminer who worked underground mining for over 23 years. The claimant originally appealed the Administrative Law Judge’s decision denying benefits, contending that the judge erred in weighing the evidence in failing to find total disability. After careful consideration, the Benefits Review Board found the judge’s denial of the claimant’s benefits was appropriate. The board found that the claimant had not established total disability, a change in condition or a mistake in fact on the appeal. Consequently, the employer prevailed. 

Benjamin Durstein (Wilmington) successfully contested an evidentiary motion before the Industrial Accident Board. The Board denied the claimant’s motion to exclude surveillance evidence produced after the “30-day deadline,” reasoning that the probative value of the evidence outweighed the prejudice to the claimant. The evidence was deemed admissible for impeachment purposes.

Benjamin Durstein (Wilmington) also successfully litigated two petitions before the Industrial Accident Board. The Board denied the claimant’s petition for additional compensation due on all counts and granted the employer’s petition to terminate total disability benefits. Specifically, the Board concluded that: (1) a proposed left ankle reconstruction surgery was not reasonable and necessary; (2) there was insufficient evidence to prove a compensable left knee injury; (3) there was insufficient evidence to prove a compensable lumbar spine injury; and (4) the claimant was capable of unrestricted work effective August 18, 2021.

Michael Sebastian (Scranton) successfully litigated a petition to terminate the claimant’s benefits. The claimant also filed claim and penalty petitions, alleging a left hand and thumb injury that required surgery. The Workers’ Compensation Judge granted the claim petition and awarded the payment of medical benefits. However, the judge did not order the payment of any indemnity benefits based on: (1) the claimant’s post-injury termination for cause; and (2) the testimony of the employer’s witnesses that work, even one-armed work, was available to the claimant. Also, the judge terminated the claimant’s benefits based upon an IME report.

*Prior Results Do Not Guarantee A Similar Outcome
 

What’s Hot in Workers’ Comp is prepared by Marshall Dennehey Warner Coleman & Goggin to provide information on recent legal developments of interest to our readers. This publication is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. We would be pleased to provide such legal assistance as you require on these and other subjects when called upon. ATTORNEY ADVERTISING pursuant to New York RPC 7.1 Copyright © 2021 Marshall Dennehey Warner Coleman & Goggin, all rights reserved. No part of this publication may be reprinted without the express written permission of our firm. For reprints or inquiries, or if you wish to be removed from this mailing list, contact tamontemuro@mdwcg.com.