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Zero Tolerance!

Oct 20, 2022 | Firm News

Neil A. Diegelman, Associate Attorney

When a claimant is working and collecting worker’s compensation indemnity benefits and does not disclose to anyone that they are working, they have likely committed fraud. In a recent case LOMAD was handling, a claimant testified under oath on two occasions that he was not working and awards were updated at a temporary rate based on claimant’s testimony they were not working. LOMAD raised fraud and, at the hearing, the claimant testified that he was performing light work for friends, family, and church members. The claimant had seen both a treating and an IME doctor between the first testimony and the fraud testimony and advised he was not working.

Further, the claimant was apparently displaying such an injured state that his treating doctors had advised the claimant to use a wheelchair to ambulate. However, once the videos were disseminated, it was clear that the claimant had violated WCL section 114-a. The video showed the claimant performing residential construction work and working his personal business. During summations, LOMAD aggressively argued that lying strikes at the very heart of the judicial system and argued that, without honesty, the system runs afoul. We argued the claimant lied to the court on multiple occasions, lied to every single doctor, lied to defense counsel and lied to their own attorneys. We argued for a mandatory retroactive penalty beginning on the date of the IME, at which point the claimant advised he was not working. (The claimant was clearly working, however, as we had surveillance of the claimant leaving the IME appointment and going to work!) We argued that, honesty strikes at the very heart of the judicial system and here, due to the serious and egregious nature of claimant’s lies, they should be forever barred from receiving additional wage replacement benefits.

The WCLJ found that the claimant’s lying was extensive, in that the claimant went to the IME and said they were not working but then immediately proceeded to work at the residential construction project. The WCLJ noted that the claimant lied to everyone and that warranted a mandatory and discretionary lifetime ban on indemnity benefits. This was a great win for our client, as this claimant was “caught red-handed,” and only once the claimant was confronted about their work activities did they finally admit to their work status.

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