When a carrier accused a bricklayer of concealing prior injuries, the Workers' Compensation Board found the evidence failed to establish that the prior insurance claims actually involved the claimant.
Case
Matter of Loja-Saula v. Cosan Construction, No. CV-25-0822 (N.Y. App. Div. 09/03/26)
What Happened?
A New York bricklayer filed a claim for workers' compensation benefits for work-related injuries after a piece of a concrete cinderblock fell on him. Following a hearing, a Workers' Compensation Law Judge established the claim for injuries to the bricklayer's head, left shoulder, and back, but disallowed the claim for injuries to his neck, left wrist, and left knee.
On review, the Workers' Compensation Board modified the WCLJ's decision by amending the claim to include injuries to the neck, left wrist, and left knee. At a subsequent hearing, the employer's carrier alleged that the bricklayer failed to disclose prior injuries to the sites listed in his C-3 claim form, which would violate Workers' Compensation Law Sec. 114-a. The WCLJ found that the bricklayer had violated Workers' Compensation Law § 114-a
On administrative review, the Board found insufficient proof that the bricklayer violated Workers' Compensation Law § 114-a and rescinded the WCLJ's decision. The carrier appealed.
Rule of Law
In New York, a claimant who, for the purpose of obtaining workers' compensation benefits, knowingly makes a false statement or representation as to a material fact shall be...
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