Summary
This Appellate Division, Third Department opinion reviews a Workers' Compensation Board decision that disqualified a claimant from receiving future wage replacement benefits after finding she violated Workers' Compensation Law § 114-a. The Board determined that surveillance video contradicted the claimant's reported symptoms and functional limitations, constituting a material misrepresentation to treating physicians. The court affirmed the Board's findings, holding that substantial evidence supported the conclusion that the claimant exaggerated her disability and that the imposed penalties were not disproportionate.
Topics
Practice areas
Questions Presented
- Whether the Board erred in finding that claimant violated Workers' Compensation Law §114-a and imposing the mandatory penalty.
- Whether the discretionary penalty of permanent disqualification from future wage replacement benefits was disproportionate to the misrepresentation.
- Whether the Board's denial of claimant's application for reconsideration was arbitrary, capricious, or an abuse of discretion.
Holdings
- The Board's finding that claimant materially misrepresented her disability and the imposition of the mandatory penalty are supported by substantial evidence and are not disturbed.
- The discretionary penalty is not disproportionate; the Board's assessment is within its discretion and upheld.
- The denial was not arbitrary; claimant failed to demonstrate new evidence, material change, or Board error, so the denial stands.
Key quotations
“Workers' Compensation Law § 114-a (1) provides, in relevant part, that a claimant who, for the purpose of obtaining workers' compensation benefits or influencing any determination relative thereto, knowingly makes a false statement or representation as to a material fact shall be disqualified from receiving any compensation directly attributable to such false statement or representation.” (at *2)
Factual background
Claimant Victoria A. Carpenter, a registered nurse, sustained a work injury in 2014 that led to complex regional pain syndrome. Surveillance video taken in 2021 showed her performing physical activities without apparent limitation, contradicting her medical reports and leading the Board to find she materially misrepresented her condition, violating Workers' Compensation Law §114-a.
Procedural history
The Workers' Compensation Board found the claimant violated Workers' Compensation Law §114-a based on surveillance video showing misrepresentation of disability, imposed a mandatory penalty rescinding benefits and a discretionary penalty of permanent disqualification, and denied the claimant's application for reconsideration. The appellant appealed those determinations to the Appellate Division, Third Department.