Firm Obtains “Take Nothing” on previously accepted claim!
The above case was referred to Christian Colantoni at our firm in November of 2017 at which time it was already set for Expedited Trial on the issue of temporary disability. At the time, the matter involved an accepted specific injury. The Application for Adjudication of Claim filed in February 2017 stated the injury occurred on January 3, 2017. Upon referral and review of the initial claim materials, it was noted that the claim was not reported to the insured until January 24, 2017, and at that time was claimed to have occurred at noon on January 23, 2017. After the initial Expedited Hearing on the issue of disability benefits, the applicant’s deposition was set. During applicant’s deposition, it was noticed that the applicant was not truthful about his past work and educational history when compared with the initial QME report from Dr. Linda Cintron. Applicant was questioned during the deposition by the undersigned with regard to these discrepancies; however, he did not admit the information that he presented to the QME physician.
Immediately after the deposition, hospital records were subpoenaed concerning applicant’s treatment for the accepted injury of January 3, 2017. Upon a detailed review of the subpoenaed records from Sequoia Hospital, it was learned that a January 10, 2017 medical report existed, in which the applicant claimed that he had fallen on January 3, 2017, while removing Christmas lights at his personal residence. This information factually contradicted the applicant’s claims of injury at work on January 3, 2017. Despite producing this evidence to applicant’s counsel, the case remained disputed and applicant refused to dismiss or settle his claim and requested to push forward to trial. After review with the client, a decision was made to issue a denial letter based on new information obtained after the initial 90-day investigation. The file was converted after the initial payment of benefits and disability indemnity to denied status.
Unfortunately, Dr. Cintron had removed herself from the QME participation and a new QME needed to be selected. The new QME evaluator reviewed not only these records contradicting the place and location of the injury but also sub rosa video surveillance of the applicant working subsequent to his deposition. The QME was then cross-examined with regard to the discrepancies between the Sequoia Hospital records and applicant’s allegations.
Applicant, still refusing to resolve his claim despite the implications in the records, requested trial. Defense counsel and applicant proceeded to day one of trial on September 24, 2020, and completed day two of trial on December 17, 2020. Both days of trial included extensive review prior documents and relevant portions of sub rosa video surveillance. Trial was conducted via Lifesize video.
After review of all the inconsistencies in the case including the applicant’s alleged perjury during deposition and alleged perjury during trial, the matter stood submitted. On February 4, 2021, Judge Suh issued a Order that the applicant “take nothing” finding the applicant’s credibility completely lacking and multiple and repeated impeachment of the applicant’s deposition testimony and trial testimony.
To view a copy of the Opinion and Order, please click here.