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Joana Y. Coloma Secures Defense Verdict in Workers’ Compensation Case

May 14, 2024

New York Associate Joana Y. Coloma recently achieved a defense verdict for our Workers’ Compensation team. The case arose out of the claimant’s allegations that a fire extinguisher fell on her during the course of her work duties and caused her to sustain injuries to the head (brain), neck, back, and left knee. The claim was denied by the insurance carrier due to the inconsistencies noted in the claimant’s reporting of the incident, subsequent complaints, and what was observed in the carrier’s video surveillance. At the pre-hearing conference, the Law Judge found prima facie medical evidence of work-related injuries to the listed sites, and the carrier was directed to produce an Independent Medical Examination regarding a causal relationship. Despite the carrier’s orthopedic IME, which conceded causality, the carrier moved forward with the claim controversy and deposed the claimant’s treating physicians on the issue of a causal relationship. 

The scheduled trial for this case began with Ms. Coloma’s introduction of the video footage, followed by a brief discussion between the parties and Law Judge regarding the filming location and details thereof, resulting in the Judge’s acceptance of the video into the record. After the claimant underwent direct examination, Ms. Coloma cross-examined the claimant, focusing on certain facts of the accident that cast doubt on the claimant’s statements about the incident and her reported symptoms. Ms. Coloma also inquired about the claimant’s treatment following the incident and highlighted the claimant’s conflicting statements given to several physicians, displaying her lack of credibility. 

During her testimony, the claimant was unable to explain why there were inconsistencies in her verbal and written statements and could not answer several of the questions Ms. Coloma presented. Ms. Coloma’s cross-examination also revealed that the claimant had previously been in an accident during which she slipped and fell – a direct contradiction to her initial denial of a prior injury of similar nature.

After viewing the surveillance video, which had limited visibility, the Law Judge rendered a defense decision without requiring lay witness testimony on the grounds that it would have been impossible for the accident to have occurred in the manner it was reported by the claimant, given her testimony. The Law Judge also addressed the two physicians’ depositions on causality, acknowledging that their depositions relied on the accident history reported by the claimant, which was determined to be unreliable due to the inconsistencies between the claimant’s testimony and written statements. The claim was disallowed in its entirety.

Joana Y. Coloma is a member of the Workers’ Compensation and Special Investigations Unit / Insurance Fraud Litigation teams at Manning Kass, and she is currently a member of the New York State Academy of Trial Lawyers.

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