Court Says No Fraud Because Worker Didn’t Purposely Lie About Drinking

Court Rules Drunk Driving Claim Isn’t Fraud Without a Direct Lie

  • A worker sitting in his car got hit by another car while sitting on the shoulder after a minor fender bender.
  • Even though his blood alcohol was .18, the court previously ruled that being drunk wasn’t the “sole cause” of the crash.
  • The employer argued the worker committed fraud by hiding his drinking.
  • The court shot that down because the worker never actually denied having a few drinks.

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Court Affirms Occupational Disease and Penalty Against Carrier

  • A brick mason was awarded workers’ compensation for hand and knee injuries caused by twenty-five years of repetitive labor. 
  • While an appeal was pending, the insurance carrier unilaterally subpoenaed the claimant’s doctor for a third deposition without Board approval. 
  • The court upheld the occupational disease claim based on competent medical evidence. 
  • It also affirmed a $500 penalty against the carrier for initiating a frivolous proceeding.

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Court Rejects Preclusion of Medical Exam for Correction Officer

  • A New York court said the Workers’ Compensation Board was right to allow the insurer’s IME report in a correction officer’s injury case. 
  • The worker argued the report should be thrown out because the State Insurance Fund didn’t file one of the required IME forms. 
  • The court found the carrier still met the notice rules. 
  • The insurer’s lower SLU ratings will stay in the case.

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