No Violation of N.Y. Workers’ Comp. Law § 114-a Where Testimony Inconsistencies Explained by Head Injury
A New York appellate court affirmed a finding of a state WCLJ, affirmed by the New York Workers’ Compensation Board, that a claimant had not made misrepresentations regarding his prior health conditions in order to obtain workers’ compensation benefits in violation of N.Y. Workers’ Comp. Law § 114-a, where the inconsistencies were adequately explained by his traumatic head injuries in a worker-related accident [Matter of Belfiore v. Penske Logistics LLC, 2022 N.Y. App. Div. LEXIS 5447 (Oct. 6, 2022)].
Background
In February 2020, 2020, claimant, a hospital delivery driver, sustained head and traumatic brain injuries from a fall while unloading material from a truck at work. The employer and its workers’ compensation carrier controverted his claim, contending, inter alia, that the fall resulted from claimant’s preexisting medical condition and was not causally-related to his work.
After a hearing, at which the carrier did not appear, the WCLJ, relying on the findings contained within an IME physician’s report, established the claim for an injury to claimant’s head and for a subdural hemorrhage, a subarachnoid hemorrhage, an intraparenchymal hemorrhage, multiple skull fractures and a right posterior parietal scalp hematoma. The Board denied the carrier’s subsequent application for Board review, and that determination was affirmed upon appeal to the Appellate Division (3d Dept.).
§ 114-a Violation
The carrier also raised the issue of a N.Y. Workers’ Comp. Law § 114-a violation, alleging that claimant intentionally misrepresented his medical history during his testimony and during the IME. Following hearings on that issue, the WCLJ found insufficient evidence that claimant knowingly made material misrepresentations to obtain benefits. The Board affirmed the WCLJ’s decision and subsequently denied the carrier’s application for full Board review. The carrier appealed.
Claimant’s Memory Issues Clearly Established
The appellate court noted that claimant’s medical records clearly contradicted his statements that he had no history of fainting, dizziness or syncope prior to the accident. Nevertheless, said the court, claimant testified, and the medical evidence—including the IME report—confirmed, that claimant suffers from memory loss as a result of the severe head and brain trauma suffered in the accident. Claimant provided a release for his medical records and testified that, in the event there were any discrepancies between his testimony and the information reflected in his medical records, that the medical records were correct.
The court further observed that claimant had explained that he remembers some things, but that there are gaps in his memory. He indicated that he was not trying to hide any information. Absent any evidence by the carrier that claimant did not suffer from memory loss, the Board credited claimant’s explanation regarding the misstatements. The appellate court deferred to the Board’s credibility determination, finding substantial evidence supported the Board’s conclusion that claimant did not knowingly making false misrepresentations and, therefore, did not violate N.Y. Workers’ Comp. Law § 114-a.