Workers' Compensation Case Status and Strategy

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Summary

An overview of a current workers' compensation claim, including medical status, legal disputes, settlement negotiations, and surveillance results.

Workers' Compensation Case Status and Strategy

Highlights

Medical and Legal Status

The claim covers a back injury and a consequential left wrist injury. A request for left wrist surgery was denied due to lack of evidence, and an objection has led to a pending hearing. Current treatment remains conservative, with a new IME scheduled for August 2026.

Apportionment and Fraud Investigation

Defense counsel is seeking records from a 2019 New Jersey workers' compensation case to address apportionment. The claimant denied prior injuries, and if evidence of prior treatment is discovered, the defense intends to pursue a fraud claim under S114A, which could disqualify the claimant from future indemnity benefits.

Settlement and Surveillance

While the claimant is interested in settlement, the current 325K demand is considered excessive. The strategy remains to push toward Maximum Medical Improvement for a permanent partial disability classification. Recent surveillance has been ineffective, and further efforts are pending instruction.

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