July 5, 2024

Kelley Kronenberg Triumphs in High-Stakes Workers’ Compensation Fraud Case

In a resounding victory for employer rights, Kelley Kronenberg Partner/Business Unit Leader Amy Siegel, alongside Associate Davona Johnson and Legal Assistant Gabby Cotroneo, secured a complete defense verdict in a complex workers’ compensation case involving fraud. The non-jury trial was presided over by Judge of Compensation Claims Iliana Forte in Fort Lauderdale, Florida.  

The case originated from an April 27, 2023, incident on the employer’s property, in which Claimant attempted a precarious U-turn in a commercial vehicle. Despite the relatively minor nature of the event, Claimant subsequently wove a tapestry of increasingly dramatic narratives, ranging from claims of the cab flipping onto its side to allegations of rubble-strewn chaos and a near-death experience.  

Leveraging her extensive experience and sharp legal acumen, Amy orchestrated a formidable defense strategy. She meticulously dissected Claimant’s inconsistent accounts, juxtaposing them against irrefutable video evidence that painted a starkly different picture of the incident. Dozens of instances of misrepresentation and inconsistency were presented to the JCC, based on an intensive process of legal archaeology, digging up significant dirt on Claimant’s medical and claim history. This painstaking approach laid bare Claimant’s attempts to manipulate the workers’ compensation system for personal gain.  

Amy invoked the misrepresentation clause under Section 440.105, Florida Statutes. An affirmative defense, the legal burden was on Amy to prove Claimant had relinquished his right to benefits. Her compelling argument demonstrated that Claimant’s deliberate fabrications undermined his current claim and jeopardized his eligibility for any future benefits under Section 440.09(4).  

Judge Forte’s ruling was unequivocal: “I find Claimant fraudulently made misleading statements in order to receive workers’ compensation benefits… Thus, I find that the claimant is barred or disqualified from receiving further workers’ compensation benefits.”   

The implications of this victory are substantial. Amy and her team demonstrated the value of rigorous legal representation, successfully shielding the client from an estimated $50,000 in potential liability. This case highlights the importance of thorough investigation and steadfast defense against fraudulent claims.  

We extend our gratitude to the team at Seacor Holdings as well as the Helmsman Adjuster for their patience and willingness to sit through endless meetings, ultimately testifying in support of our defense. 

Learn more about Kelley Kronenberg’s Workers’ Compensation practice here: https://www.kelleykronenberg.com/our-practices/workers-compensation/  

Amy Siegel is renowned for her handling of catastrophic workers’ compensation claims. For more information about this practice area, click here: Catastrophic Claims (kelleykronenberg.com)