Successes

 

Suspension of Benefits Under WC-240

 

Our attorneys successfully represented an employer in a workers’ compensation claim, including defending appeals in the Appellate Division and Superior Court, securing the employer a credit for past income benefits paid to a claimant and suspending claimant’s benefits going forward after claimant unjustifiable refused offered suitable employment, was terminated for reasons unrelated to his injury, and failed to prove that he had looked for other work.

 

Staph Infection Unrelated to Work

 

Claimant, while working at a chicken processing plant, claimed that she contracted a staph infection as a result of exposure at work while performing her job duties.  Claimant sought TTD benefits and medical treatment.  At a hearing, BCH successfully argued that Claimant’s injury did not arise out of and in the course and scope of the employee’s work for the employer.

 

Our attorneys relied on three primary sources of evidence in defending this claim.  First, the employee’s treating physician, in a questionnaire, stated that her injuries were not caused by or aggravated by her work with the employer.  Second, a physician provided by the employer stated that staph bacteria naturally occurs on the skin and that there was no way to prove the water at Claimant’s workplace contained bacteria without testing the water.  Third, the employer’s quality assurance manager testified that the quality assurance department ran tests on the employee’s department and all of the tests had negative results.  Based on this evidence, the ALJ held that Claimant failed to prove her injury occurred in the course of her work beyond a preponderance of credible evidence. 

 

Pre-existing Condition

 

Claimant, a cook at a restaurant, injured his back while throwing trash into a dumpster.  His workers’ compensation claim was accepted as compensable and indemnity and medical benefits were paid.  He received medical treatment the day of his injury and was diagnosed with a lumbar sprain.  Over the following two months, Claimant continued to have regular doctor appointments and began to complain of pain in his legs.  An MRI was performed and revealed that he had a shallow disc bulge, which was similar to an MRI performed three years prior.  One month after the MRI, the authorized treating physician determined that Claimant had reached maximum medical improvement and released him to full duty without restrictions. 

           

Claimant continued to see another physician with complaints of back and leg pain.  Although he had been released to full duty work, he complained that even sedentary work caused severe pain.  At the hearing, Claimant testified that he injured his back in the early 1990’s and also suffered a lumbar sprain in 2005 or 2006.  These admissions were contrary to what he told his physicians and to his deposition testimony.  Employer also presented medical evidence from an IME where the doctor determined that Claimant’s current pain was due to his pre-existing condition and was unrelated to the subject injury.  The ALJ held that the significant pre-existing spinal problems were the cause of his pain and along with his contradictory testimony, Claimant failed to provide proof beyond a preponderance of credible evidence.  Claimant’s request for reinstatement of TTD benefits and additional medical treatment was denied. 

 

Lack of Credibility

 

Claimant filed for workers’ compensation claiming injury as a result of repeated use of a pressure washer during his job duties.  He testified that he reported the injury to his supervisor and to HR.  However, his supervisor and the HR representative testified Claimant never reported an injury.  Claimant was subsequently terminated for insubordination.  Eight months after being terminated, Claimant visited a doctor at the request of his attorney and was diagnosed with trigger finger and provided treatment.  The ALJ found that Claimant’s testimony was not credible due to his prior felony convictions, which were related to deception, and because he had been impeached by the use of several prior inconsistent statements.  The ALJ found the representatives of the employer to be more credible and that there was no notice.  Further, there was no medical evidence of an injury until nine months after Claimant was terminated and the doctor did not address causation.  Therefore, Claimant’s claim was denied.