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Results

  • Defense Prevails in Workplace Injury/Premises Liability Case

    ​The defendants were two family-owned companies that grow, process and sell mushrooms. One defendant, our client, owned the property, and the other operated the business there. The plaintiff worked for an independent company that was contracted to load compost into the defendants’ mushroom beds. The plaintiff encountered a problem with the equipment used to lift the compost (the source of the problem is in dispute). A connection between components broke, and a metal pan fell on the plaintiff’s arm, crushing it. The plaintiff alleged he had previously reported the problem to the defendants. Our attorneys successfully argued that the defendant who owned the property was a “landlord out of possession” and not responsible for injuries to third parties on the premises. The plaintiff argued that his complaint to one defendant about the equipment problem was notice to both, because both companies were owned by the same family. The court ruled that the shared ownership of the companies did not impose a legal duty on a defendant that was not otherwise responsible for the property.

  • New York Labor Law Case Dismissed on Summary Judgment

    Our client owned a parcel of land upon which a building was being erected. The plaintiff, an employee of a subcontractor, was at the premises cleaning up the worksite on a Saturday morning. He was standing on top of a company-owned work van in the parking lot, securing ladders to the roof of the van, when he slipped and fell off the van to the ground, sustaining serious leg and knee injuries. He underwent two knee surgeries and was also told he needed back surgery. The plaintiff sued our client, as the owner of the property, and the general contractor under Labor Law sections 200, 240 and 241(6). Labor Law section 240, also known as the “scaffold law,” imposes absolute liability to the landowner for height-related injuries that occur at construction sites when someone falls off a building or building under construction. Section 241(6) involves violations of the Industrial Code. At the close of depositions, we filed a summary judgment motion to dismiss all allegations of the Labor Law in that our client was not directing or controlling the plaintiff when he was injured. We further argued that the plaintiff fell off a motor vehicle, not from a building or anything construction-related, as the vehicle was in the parking lot adjacent to the construction and, therefore, the scaffold law did not apply. The court granted our motion in its entirety.

  • Summary Judgment in a Construction Accident Case in Philadelphia Court of Common Pleas

    ​Our client was the roofing contractor on a project in Philadelphia. The plaintiff was an employee of a subcontractor of our client. The plaintiff was injured when he fell through a skylight cutout in the roof. He fell approximately 15 feet and sustained injuries, including a broken hip (requiring ORIF) and fractured vertebra. The plaintiff was hospitalized for one month. The last settlement demand was $2.5 million. We moved for summary judgment based upon arguments that our client, the roofing contractor who did not occupy the site nor control the work, breached no duty of care to the plaintiff. The court granted summary judgment.

  • Unanimous Defense Jury Verdict in One of the First Pennsylvania Civil Jury Trials Held During COVID-19 Pandemic

    The verdict came within 30 minutes of deliberation in a five-day Bradford County PA fire-loss subrogation trial. Social distancing protocols were in place: all participants had their temperatures taken before entering the courthouse; jury selection took place at a local school auditorium; everyone in the courtroom was required to wear masks or face shields; and the jurors were spread out to the gallery section of the courtroom instead of the jury box. Witnesses could appear via Zoom. Two witnesses were flawlessly broadcasted to the courtroom with help from the firm’s Allentown and Mount Laurel offices.

  • No-Cause Verdict on Behalf of National Trucking Company

    We obtained a no cause verdict following a one day non-jury trial (conducted virtually) in the Law Division of Hudson County for our client, a national trucking company. The plaintiff alleged the truck swerved into his lane causing property damage. The defense successfully argued that the plaintiff’s identification of the trailer as belonging to our client was not dispositive on the issue of the identification of the company responsible for operation of the truck which was pulling the trailer at the time of the accident. The judge further found the police report was not admissible on the identification of the operator of the vehicle and also that regardless of identification, the plaintiff failed to establish the operator was negligent.

  • Amicus Curiae Brief on Behalf of PDI and PADC

    Marshall Dennehey’s appellate attorneys filed an amicus curiae brief on behalf of the Pennsylvania Defense Institute and Pennsylvania Association of Defense Counsel in a case pending in the Pennsylvania Superior Court that involved interpretation of a “regular use” exclusion that commonly appears in underinsured motorist coverage in automobile policies. The Superior Court enforced the exclusion, as PDI and PADC had requested. The plaintiff regularly used a company vehicle for his daily work. But one or two days before the accident, the specific vehicle he had been driving was taken out of service for repairs, and his employer rented a replacement vehicle for the plaintiff’s use. The insurer denied the UIM claim, based on the “regular use” exclusion, because the plaintiff was driving a company vehicle, which was his regular practice. The plaintiff countered that the vehicle he was operating at the time of the accident had not, in fact, been made “regularly” available to him because he only began using it a day or two prior. Relying on its prior decision in Brink v. Erie Ins. Group, 940 A.2d 528 (Pa. Super. 2008), which held that the “regular use” exclusion properly barred coverage for a plaintiff injured in a “fleet vehicle,” even though the plaintiff may have driven a different specific vehicle each day, the Rawl court held that the employer’s temporary rental of a replacement vehicle triggered application of the “regular use” exclusion and barred coverage. “Stated simply,” Rawl explains, “it does not matter whether Mr. Rawl had regular use of a particular vehicle furnished by his employer, but whether he regularly used a vehicle supplied by his employer.” The court, therefore, affirmed the trial court’s award of summary judgment to the carrier.

  • Appellate Success in Campground Negligence Lawsuit

    We obtained a per curiam affirmance in the Fourth District Court of Appeal in a suit against a campground/RV park. The suit alleged that the campground negligently maintained the campsite and failed to keep the electrical up to code, forcing an RV owner to abandon her RV at the site. The campground countersued for writ of distress to remove the unsightly vehicle from the campsite. The trial court entered judgment on the pleadings and declined to amend the complaint, finding an amendment would be futile. The Fourth District Court of Appeal affirmed the trial court’s entry of final judgment in favor of the campground on the main claim as well as the counterclaim. The court also conditionally granted the campground’s motion for appellate attorney's fees and remanded the case to the trial court to rule on the validity of the unaccepted proposal for settlement.

  • Dismissal of Complaint Under New Jersey’s Charitable Immunity Act

    Marshall Dennehey was successful in the New Jersey Appellate Division, which affirmed the dismissal of the plaintiff’s complaint under New Jersey’s Charitable Immunity Act. The defendant operated a shelter for battered women, their dependent children and the homeless. The plaintiff and her child were residents at the shelter and beneficiaries of its charitable goals when the plaintiff slipped and fell on ice on the shelter’s property. She argued that she was not a beneficiary of the charity because she did administrative tasks and volunteered in the charity’s thrift store. However, the trial court and Appellate Division rejected those arguments, holding that the plaintiff’s presence on the defendant’s property was due to her being a resident beneficiary of the charity, not as a result of any volunteer work she may have performed for the defendant. Thus, because her volunteer activities were incidental to her residency at the shelter, the Charitable Immunity Act applied and the dismissal of the complaint was affirmed.

  • PIP Case Dismissed at Trial

    Obtained a dismissal at trial in Civil Court of the City of New York, Queens County. ​The plaintiff, an acupuncture facility, alleged wrongful denial of personal injury protection/no-fault benefits relating to acupuncture services rendered to its assignee, a claimant who sought benefits under the defendant-carrier’s policy. The trial judge granted dismissal of the complaint on the basis of the carrier’s defense, that payments were issued in accordance with the applicable fee schedule and, therefore, nothing further was owed to the plaintiff.

  • Successful Defense of Marine Construction New York Labor Law Case

    Marshall Dennehey successfully obtained summary judgment, dismissing all claims against our client in a marine construction New York Labor Law case in the Supreme Court in Rockland County. ​The case involved bodily injuries sustained to an employee of our client, a sub-subcontractor at the site of the new Mario Cuomo Bridge. The property owner, general contractor and the subcontractor each cross-claimed and/or third-partied our client into the case, all seeking contractual and common law indemnity and contribution pursuant to the terms and conditions of the various contracts. We argued, and the court agreed, that since there was no finding of negligence against our client in causing the injuries sustained to the plaintiff, the indemnification clauses were not implicated. The court found there was no evidence demonstrating that our client caused, in whole or in part, the injuries the plaintiff sustained. The plaintiff and general contractor filed motions to reargue, which were denied.

  • Summary Judgment in PIP Case

    We obtained summary judgment in Civil Court of the City of New York, New York County. ​The plaintiff commenced an action seeking reimbursement of PIP benefits under the defendant-carrier's policy for anesthesia rendered to the claimant during a surgical procedure. After establishing that the claimant failed to appear at multiple, duly-scheduled independent medical examinations—a condition precedent to coverage—the complaint was dismissed.

  • Unanimous Defense Verdict in Asbestos Trial in New Mexico - Plaintiff Sought Nearly $40 Million in Damages

    We obtained a unanimous 12-0 defense verdict after a two-week trial in Santa Fe County, New Mexico, where the plaintiff was seeking approximately $40 million in damages. In this asbestos litigation case, it was alleged that the decedent contracted mesothelioma and died at the age of 76 as a result of being exposed to asbestos-containing joint compound manufactured and sold by our client. The decedent worked as an electrician for 40 years and contended he worked in the vicinity of drywall workers at various commercial worksites throughout Albuquerque and New Mexico. The plaintiff claimed that our client’s joint compound was defective because it was sold without a warning of the well-established dangers of asbestos. Further, the plaintiff argued that our client was negligent because it knew or should have known of the dangers of asbestos, which were readily known from as early as the 1930s. The defense argued that the asbestos fiber used in our client’s joint compound was safe because the fibers were short fibers and not known to increase the risk of disease. It was further argued that our client acted reasonably and in a timely manner when it placed a government-mandated warning on their product in the early 1970s. Lastly, it was argued that the only product identification witness called by the plaintiff was not credible because he gave three depositions in 2017 and did not identify our client’s product. He first identified our client’s product during his fourth deposition in late 2019, when our client was the only remaining defendant. The jury found our client’s product was not defective, but that they were negligent. However, the jury found the negligence was not a cause of the decedent’s mesothelioma.

  • Contractual Indemnification Key to Successful Defense of Premises Liability Case

    We obtained summary judgment on behalf of a commercial tenant in a premises liability case. The plaintiff brought suit against our client, the commercial landlord and the City of Newark. The plaintiff alleged that the parties failed to maintain a condition of the sidewalk that caused a trip and fall. We moved for summary judgment for contractual indemnification, arguing that the co-defendant commercial landlord was obligated under the language of the lease to indemnify our client for the landlord’s own negligence. At oral arguments, we were able to establish that the language of the lease was clear and that it was undisputed that our client had no duty to the plaintiff. Furthermore, we were able to argue that the motion was not premature, as the co-defendant’s opposition conceded that, based on the language of the lease, we had no duty. The judge agreed with our arguments, and the court granted our motion for summary judgment and required the landlord to indemnify our client.

  • Defense Verdict for Driver Despite his Conviction for Driving Under the Influence

    We obtained a defense verdict in a Bucks County case on behalf of a driver despite his conviction for driving at the time under the influence of alcohol and drugs. The accident occurred at an intersection controlled by a flashing traffic light. The defendant was traveling in the direction of the yellow flashing light. The plaintiff testified that he stopped at the painted stop block for the red flashing light. The plaintiff looked both ways, and believing that all was clear, proceeded into the intersection. The plaintiff saw the defendant coming from his left at a high rate of speed, only an instant before the accident. The defense argued that the plaintiff’s position at the painted stop block did not allow for adequate sight lines, and that under Section 3323(b) of the Motor Vehicle Code he was obligated to move forward to a point where he had a clear view of approaching traffic.

  • Court Agrees Mode of Operations Does Not Apply in Retail Liability Case

    We were successful on a motion for summary judgment, thereby barring the application of the mode of operations in a slip and fall case where an alleged partially eaten sandwich was found in the aisle of the retailer. ​The facts indicated that the sandwich came from a fast-food sandwich shop within the premises and was dropped by an unidentified customer, who took the item to go and dropped it in the aisle before the plaintiff fell. The court ruled that the mode of operations did not apply because the aisle, which contained greeting cards and the like, and did not create an extension of the cafeteria within the retailer’s premises. Further, the court ruled there was no nexus to any self-serve component of the fast food restaurant’s business to the area in the retailer’s store proper where the accident occurred.

  • Defense Knocks-Out Plaintiff

    We obtained summary judgment on behalf of a boxing gym. ​The plaintiff, a seasoned boxing coach, claimed to have been injured when he fell out of a boxing ring during a sparring match at the defendant’s gym. The plaintiff asserted that while standing on the apron with his back to the ring, he was struck by one of the fighters and propelled out and onto the floor. He alleged the defendant was negligent because the boxing ring was “too high” and the flooring surface “too hard.” In granting the defendant’s motion for summary judgment, the court found first that the defendant owed no duty to the plaintiff because Pennsylvania law imposes no duty on sports facilities to protect spectators from risks that are common, frequent, and expected, and that the circumstances surrounding the incident eliminate any duty on the part of the defendant. The court also held that there was no evidence to support the plaintiff’s contentions that the boxing ring was too high or that the lack of padding on the surrounding floor was a deviation from an established custom. In fact, the evidence established that the boxing ring complied with national boxing regulations. Accordingly, summary judgment was granted, and the plaintiff did not appeal the decision.

  • Successful Defense of Dog Mauling Claim

    We successfully defended a significant dog mauling case against a landlord defendant. ​The plaintiff was fortunate to have survived the attack and suffered severe permanent physical and emotional trauma. The parties stipulated to damages of $1.75 million and submitted the case to binding arbitration on liability only. The case rested entirely on the credibility of the landlord who claimed that he had no knowledge that the tenant had a dog on the property. The law requires that the landlord know that the dog is present on the leased property and has actual knowledge of the dog’s dangerous propensities. There was a lot of evidence that the dog had exhibited very aggressive behavior to anyone it came into contact with prior to the event. The plaintiff argued that the landlord had to know of the presence of the dog and its dangerous propensities given the number of times the landlord visited the property. The arbitrator found in favor of the plaintiff and against the tenant only.

  • Summary Judgment in New York Labor Law Case

    We represented a plumbing subcontractor in a case venued in Supreme Court, Bronx County. ​The plaintiff alleged he sustained serious neck and back injuries as a result of falling pipes. The plaintiff had been hired by a subcontractor involved with boiler replacement work at a large residential building located in Manhattan. The plaintiff alleged violations of Labor Law Section 200, 240 and 241(6). These claims were alleged against the building owner, management company and various subcontractors at the site. The plaintiff alleged he sustained cervical and lumbar injuries resulting in a cervical fusion and lumbar discectomy. He also allegedly sustained a fracture of the thoracic spine. As a result of the accident, the plaintiff claimed he could not return to work. The settlement demand made before the motions were filed was in excess of $10 million. The court granted our summary judgment motion in its entirely and dismissed all claims against our client on the basis that our client had absolutely no involvement with the accident, having only performed work on the upper floors of the building. The court order also granted the cross motions by the other defendants, resulting in a complete dismissal of all claims against all defendants.

  • Company Under Fire in Product Liability Suit Had No Duty to Install or Advise to Install New Valves

    We were successful on a motion for summary judgment that was granted dismissing all claims against our client, an environmental compliance services and tank testing company, in a case where the plaintiff made an $8.75 million settlement demand. ​The plaintiffs, a minor mother and child, were at a gas station in Philadelphia when a vehicle inadvertently struck a fuel dispenser, knocking it over and causing a fire and explosion. The claims and cross-claims asserted against our client alleged it should have installed or advised the gas station owners to install a valve that would have prevented the fuel leakage that exacerbated the fire. We filed a summary judgment motion arguing that the claims and cross-claims asserted against our client went beyond the scope of the environmental compliance services it was hired to perform such that our client had no duty to either install or advise of installing different valves. The court granted our motion dismissing all claims and cross-claims against our client.

  • Defense Verdict in Plaintiff's "Leaky" Case

    We obtained a defense verdict in a three-day jury trial  in the Montgomery County Court of Common Pleas. ​The 81-year-old plaintiff, who was staying at her daughter's home, alleged that she slipped and fell on water in the basement of the rental property and injured her hip. The property was owned by our clients. The plaintiff's daughter and son-in-law claimed they repeatedly complained to our clients of leaks from the ceiling in the basement, without response. They were in the midst of eviction proceedings with our clients for failure to pay rent for several months when the fall occurred. Our clients denied any knowledge of the leaking problem alleged by the tenants, though they did admit that they were aware of leaks in other areas which they attempted to fix. The jury deliberated for 2 ½ hours, had two questions, and asked for the negligence charge to be read back to them. They then returned a finding of no negligence. There was a nuisance value settlement offer made prior to trial, which was rejected.

  • Dog Attack Claims Lacks "Bite"

    We obtained summary judgment in favor of our homeowner clients in a case involving an alleged “attack” by our client’s dog. ​As the plaintiff walked past the client's property on a public sidewalk, the dog ran out to the edge of the sidewalk barking loudly. The plaintiff became "startled" and stepped back, falling into the street and sustaining a seriously displaced left distal radius fracture that required open reduction and internal fixation. Upon review of the summary judgment motion, the court found no evidence that the dog was a "dangerous dog" or that the dog had ever left the confines of the insured's property. Interestingly, the court ruled that the dog's barking and charging the sidewalk did not represent a breach of duty by the homeowner to the public on the sidewalk under the applicable statutory and case law.

  • New York Labor Law Case Dismissed

    We obtained summary judgment in New York County in a case where the plaintiff, a construction laborer, was struck by a rolling dumpster and sustained severe crush injuries to his left foot and leg. The plaintiff, the dumpster company and the subcontractors alleged our general contractor client was responsible for overall site safety. After obtaining billing and work records for the project, the client confirmed that it did not have any involvement in the project, and we moved for summary judgment. After oral argument, the court granted our motion in its entirety and dismissed the case and all cross-claims.

  • New York PIP Action Dismissed

    We secured the dismissal of a New York no-fault/personal injury protection (PIP) lost wages suit that carried a potential judgment of more than $1.37 million. The suit commenced in 2014, and over several years, the plaintiff was not cooperative in providing requested information. In 2018, the defense served a 90-day notice on the plaintiff, which advised that we would move for dismissal if the plaintiff did not take action or file a notice of trial within 90 days. The Rockland County Supreme Court Judge recognized that there was no activity in the case for years, but was apprehensive about dismissing the case on the spot. He scheduled an additional hearing and required the plaintiff and new counsel, if retained, to appear to discuss the case status and activity. When they did not appear, Scott successfully moved for dismissal.

  • Successful Resolution of Premises Liability Action

    We successfully tried a premises liability action to a defense verdict in favor of a resident’s association in the Chester County Court of Common Pleas, and also successfully defended against the plaintiff’s appeal. ​The plaintiff, who was a community resident (formerly married to a unit owner but not an owner herself), claimed that she tripped and fell on a tree branch on common area steps at night as a result of a burned out PECO-owned lamp, and that the Association failed to ensure that the light was fixed. The plaintiff had asked for either invitee status or a hybrid charge on duty, but the court agreed with the defense that she was able to use the common areas by permission, not by invitation, making her a licensee only. This resulted in the duty owed being only to make the property as safe as it appeared. The defense presented multiple instances of notice to PECO of the burned-out light, and the plaintiff conceded the defense contention that it could not change the bulb itself because PECO owned the lamp. The plaintiff also conceded that she had been aware of the light being out for some time. The jury unanimously found in favor of the Association and, on appeal, the Superior Court affirmed the judgment on the jury verdict, finding that the trial court did not err by charging the jury that the plaintiff was entitled only to the care due to a licensee on the property, and not an invitee.

  • Rock Climbing Liability Waiver Found Enforceable.

    We obtained summary judgment on behalf of a rock climbing center. ​The plaintiff, a certified climber, was injured when she fell from a 25-foot rock-climbing wall at our client's facility. After reaching the summit of the wall, she pushed off to begin repelling down, only to realize that she forgot to connect to the auto-belay system. She fell to the ground and fractured both ankles and underwent open reduction internal fixation surgery. She had previously visited the client's facility approximately 35 times and had executed a liability waiver on each occasion, including the date of the accident. We moved for summary judgment to dismiss her complaint based upon the fact that the liability waiver was enforceable. The plaintiff argued that the liability waiver was only enforceable as to her claims of ordinary negligence, and that the issue of whether the defendant was grossly negligent was a triable issue of fact. However, we successfully argued that no reasonable jury could find that the client was grossly negligent based on the client's testimony of the safety procedures, protocols and equipment in place at the rock-climbing center. Accordingly, the court granted our motion for summary judgment and dismissed the plaintiff's complaint, in its entirety, against our client.

  • Court Dismisses Plaintiff’s Labor Law Section 200 Claim and Numerous 241(6) Industrial Code Violations.

    We were granted partial summary judgment in a Labor Law case venued in the New York Supreme Court, Bronx County. The plaintiff was installing new floors in a large residential building in Manhattan that was owned by our client. The project involved a large-scale renovation of a penthouse and several lower levels. During the renovation, the plaintiff fell through an opening in the floor and sustained injuries to his knee and back. The plaintiff moved for summary judgment under New York Labor Law Section 240(1). We cross-moved for summary judgment, seeking a dismissal of all claims. Our expert concluded that the plaintiff could have avoided the accident and that proper safety equipment was provided. The court denied the plaintiff’s motion and granted our motion in part by dismissing the plaintiff’s Labor Law Section 200 claim and numerous 241(6) industrial code violations.

  • Defense Melts Plaintiff's Snow and Ice Claim.

    We obtained summary judgment in the Supreme Court of Rockland County, New York. The plaintiff slipped and fell while walking to her mailbox during a severe winter storm in January 2016. The plaintiff initiated a lawsuit against her homeowners association and its snow removal contractor. We moved for summary judgment on behalf of the defendants, asserting that the plaintiff’s claim was barred by the storm-in-progress doctrine. In opposition to our motion, the plaintiff alleged the defendants failed to adequately salt the premises, that the defendants were aware of the icy conditions, and that the storm had ended prior to the plaintiff’s accident. In granting the defendants’ motion for summary judgment, the court found the defendants established that there was a storm in progress at the time of the plaintiff’s accident and that their efforts to prevent ice accumulation and remove snow did not create a hazardous condition. According to the court, the plaintiff’s testimony was self-serving, contradictory and a feigned attempt to create a material issue of fact as to when the storm came to an end.

  • Summary Judgment for Movie Theater Over Patron Fight in Parking Lot.

    We prevailed on an appeal before the Appellate Division, Second Department, NYC, reversing a lower court order that denied summary judgment to our client, the owner of a movie theater. The plaintiff was a patron at the movie theater, where he got into a fight with another patron over a parking spot. The plaintiff sued the theater for negligent security. The defense was able to show that there was no notice to the theater because the incident was sudden and unexpected, based on the short duration of the altercation, and the lack of similar prior incidents at the theater. The appellate court granted summary judgment to the theater.  

  • Claims Barred Under New Jersey's Charitable Immunity Doctrine.

    We obtained summary judgment in the Passaic County Superior Court of New Jersey on behalf of a non-profit shelter for battered women. The plaintiff, who was staying at the shelter at the time of her alleged incident, accused the shelter of negligence with regard to removing snow and ice from their parking lot. The plaintiff attempted to argue that she was not a “beneficiary” of the shelter but was a volunteer, who was not required to help but who chose to work at the shelter in exchange for room and board. Defense counsel successfully argued that the defendant was a qualified non-profit organization and that the plaintiff was clearly benefiting from the non-profit at the time of her incident. Therefore, the plaintiff’s claims were barred under the New Jersey Charitable Immunity doctrine.

  • Defense Verdict in Deli Case Premises Liability Lawsuit.

    Obtained a defense verdict on behalf of a supermarket in a premises liability case in the Court of Common Pleas of Cumberland County, Pennsylvania. The plaintiff claimed that she was injured when her hand was trapped in a deli case door that was closed by an inattentive employee. She claimed that in an attempt to free her hand from the deli case, she suffered an injury to her shoulder and her neck. MRI scans after the incident did show degenerative disc disease in her neck, as well as multiple herniated discs. Her treating orthopedic surgeon attributed the injuries to the incident in question and recommended a cervical fusion. Through investigation, we learned that the plaintiff had filed a lawsuit in New York as a result of a fall in 2007. We obtained a transcript of the plaintiff’s deposition from the prior lawsuit, which indicated that her treating physician in the New York case had recommended the same health care procedures that had been recommended after this incident. The jury did find the employee who closed the deli case door on the plaintiff’s hand to be negligent. The jury also found that the plaintiff was negligent in sticking her hand in the area of an open deli case and that the plaintiff’s negligence outweighed the defendant’s negligence, barring her recovery. 

Firm Highlights

Thought Leadership

Employer/Carriers Must Explicitly Invoke Right to Deny Claim Under “Pay and Investigate” Statutory Provision; Employes Must Always Prove Medical Necessity of Treatment

Koren v. City of Kissimmee/PGCS, ___So.3d___(Fla 1st DCA 6/10/26) The majority opinion in Koren holds that the Judge of Compensation Claims (JCC) properly denied psychiatric treatment because the claimant did not challenge on appeal the JCC’s finding that the requested treatment was not medically necessary. However, Judge K. Thomas authored a detailed concurrence agreeing with the result on the ground that the claimant failed to meet his burden of proving medical necessity. In doing so, Judge K. Thomas also emphasized an important principle: employer/carriers must expressly invoke the 120-day pay-and-investigate provision under Florida’s Workers’ Compensation Act if they intend to preserve their right to deny compensability. Merely authorizing evaluations, without explicitly invoking the 120-day rule, may be insufficient to preserve the right to deny compensability of specific injuries. In Koren, the claimant sustained injuries to his upper lip, tooth, right knee, and right foot when a board gave way on a deck he was repairing for the employer/carrier. The accident was accepted as compensable, and multiple specialists were authorized to treat his physical injuries, including an ear, nose, and throat physician, dentist, orthopedist, and plastic surgeon. The claimant later sought psychiatric treatment and attended an independent medical examination (IME) with a psychiatrist. The IME diagnosed adjustment disorder with mixed anxiety and depressed mood, opining that the condition was caused by “the actual appearance of the scar” resulting from the industrial accident. The IME recommended continued medication, including an antidepressant, as well as follow-up care with a psychiatrist and psychologist. Critically, however, the IME did not offer an opinion regarding the medical necessity of this treatment. The claimant then filed a petition for benefits attaching the IME report and requesting authorization of psychiatric care. The employer/carrier responded by authorizing a psychiatrist, whom the claimant did, in fact, see. However, the employer/carrier neither denied the claim nor issued written notice invoking the 120-day pay-and-investigate provision. The authorized psychiatrist subsequently opined that the claimant’s psychiatric condition was unrelated to the industrial accident and instead attributable to prior employment as a law enforcement officer and volunteer firefighter. The psychiatrist further concluded that the work accident was not the major contributing cause of the condition. Although the employer/carrier stipulated to the authorization of the psychiatrist, it ultimately denied the claimant’s entitlement to psychiatric treatment. The JCC denied the requested benefit. The majority opinion affirmed on the narrow ground that medical necessity had not been established. Judge K. Thomas’s concurrence, however, expands on the legal framework. Under Florida law, an employer/carrier presented with a claim must “pay, pay and investigate, or deny.” To avail itself of the 120-day pay-and-investigate protection, the employer/carrier must affirmatively and explicitly invoke that option, typically through a written 120-day letter. The statutory investigative period does not arise automatically upon the provision of care. Furthermore, an attempt to characterize authorization as a “one-time evaluation” does not avoid waiver, as even a single evaluation may constitute the provision of a compensable benefit. By authorizing psychiatric care without invoking the 120-day provision, the employer/carrier in Koren effectively accepted compensability of the claimant’s PTSD condition. Nonetheless, it retained the ability to contest entitlement to ongoing treatment. While the employer/carrier failed to demonstrate a break in the causal chain, the claimant still bore the burden of proving that the requested treatment was medically necessary. Because the JCC found that the claimant failed to meet this burden, and the claimant did not challenge that finding either below or on appeal, the denial of psychiatric benefits was ultimately affirmed.

Thought Leadership

Mitigating Long-Tail Liability: Delaware Court Reaffirms Five-Year Workers’ Compensation Deadline

Williamson v. Donald F. Deaven, Inc., No. N25A-07-004 FWW, 2026 LX 252526 (Del. Super. Ct. June 2, 2026) Claimant was involved in a compensable industrial work accident on May 12, 1995, for a low back injury.  Following this, he received compensation for temporary total disability benefits from July 1996 to September 1996 and for sustaining a permanent impairment in 1997 and 1998.  For the next 23 years, the claimant continued treatment and paid his own medical bills without submitting them to the employer’s insurer.  In November 2021, the claimant filed a petition seeking payment for medical expenses, including prospective surgery and a resulting period of total disability.  The employer moved to dismiss the petition, arguing it was barred by Delaware’s five-year statute of limitations (19 Del. C. § 2361(b)). Pursuant to 18 Del. C. § 3914, insurers must provide prompt written notice of the applicable statute of limitations to invoke the five-year deadline.  Due to the age of the case, neither party had a comprehensive file of the claim and the Board had archived its file of the matter.  The carrier’s computer system retained only bare information indicating that payments occurred and agreements and receipts were filed with the Board in 1997. While the claimant argued that the employer could not prove it provided the mandatory statutory notice, the Hearing Officer recovered the archived file, which contained two “Receipts for Compensation Paid” signed by the claimant.  The receipts explicitly contained the required five-year limitation language, which the claimant testified to signing at the hearing.  The claimant also attempted to introduce evidence of payments he claimed the employer made, which would have extended the statute of limitations.  As a preliminary matter, the hearing officer excluded the testimony about the payments because the claimant did not produce them to the employer.  The Board found in favor of the employer and dismissed the claimant’s petition as time-barred. The claimant appealed the Board’s decision, arguing that he never received adequate notice of the statute of limitations and that the hearing officer’s evidentiary ruling was an abuse of discretion. The Court held that the archived, signed receipts constituted substantial evidence that the insurer fulfilled its statutory notice requirements.  Therefore,  the claimant’s petition was time-barred under the statute of limitations provisions of 19 Del. C. § 2361(b).  Furthermore, the Court reinforced strict procedural compliance: it rejected the claimant’s attempts to introduce evidence of payment on appeal, ruling the argument was waived for failure to preserve it while the matter was still before the Board. This recent ruling by the Court underscores the importance and necessity of robust data preservation and precise compliance with notice requirements.  For risk managers, employers, and insurers, the decision highlights how tight administrative execution protects against catastrophic long-tail liability.

Thought Leadership

Appellate Division Affirmed Workers’ Compensation Order Striking Defenses and Ordering Treatment

Kneezel v. Lambertville House, No. A-2729-24 (June 1, 2026) In Kneezel v. Lambertville House, Lambertville House appealed from a workers’ compensation order to strike its defenses and directing it to authorize knee replacement surgery. By way of background, the petitioner worked as a property manager for Lambertville and injured his back and knee in December 2019. A workers’ compensation claim was filed and the petitioner treated at Rothman Institute. He underwent four injections to his low back and was recommended for surgery. The day before, Lambertville canceled and set up a second opinion exam with Dr. Lawrence Barr. The petitioner filed a motion for medical and temporary benefits (MMT), which was ultimately granted by the workers’ compensation judge. As such, he received authorized treatment for his back. The petitioner was then referred for his left knee pain and treatment was provided by Lambertville. He was recommended for a knee replacement, but the petitioner declined at that time. Approximately two years later, he sought additional treatment, which was denied. After obtaining a report from Dr. Dhimant Balar, the petitioner filed another MMT. In response, Lambertville submitted Dr. Zachwieja’s report and surveillance reports. Dr. Balar opined the left knee injury was related to the work accident, whereas Dr. Zachwieja believed it was due to his advanced degeneration as there was no evidence of acute trauma. A hearing on the MMT began in November 2024, with the petitioner testifying his knee pain never went away and he had a lot of trouble walking, especially for more than five to ten minutes. The surveillance investigators were scheduled to testify after, but had to be rescheduled a couple of times. During a conference in early February 2025, prior to when the investigators were to testify, it was discovered that Lambertville did not provide discovery to the petitioner, including the investigators’ information and surveillance footage. The petitioner moved to strike Lambertville’s defenses and sought an order to authorize the left knee treatment. Petitioner’s counsel pointed to Lambertville’s unreasonable delay in providing the necessary information and Lambertville did not file an opposition. In March 2025, the investigators’ testimonies were set for mid-March. On March 14, 2025, petitioner’s counsel advised she was still waiting for discovery and the judge directed Lambertville’s counsel to provide any missing information by March 17, 2025. Lambertville provided video clips after the petitioner had testified so the judge indicated that if everything was not provided to petitioner’s counsel by the end of March 19, 2025, the judge would sign the order granting the MMT. The next day, the judge entered the order striking Lambertville’s defenses and ordering left knee treatment. Lambertville moved for reconsideration of stay of the order pending appeal. Following oral arguments, the judge denied Lambertville’s motion, citing N.J.A.C. 12:235-3.11 (a)(4)(i) that Lambertville was required to provide surveillance after the petitioner’s testimony and that it had failed to do so even after he testified in November 2024. The judge also noted the investigators’ testimonies were rescheduled multiple times and Lambertville had more than enough time to provide the requested information and failed to do so. The judge also noted Lambertville failed to file a response to the petitioner’s motion to strike. In addition, the judge pointed to the petitioner’s testimony, finding him to be credible and observing him to have to stand and move multiple times during testimony. Lambertville appealed, arguing its due process rights were violated as there was no opportunity to be heard and the order was procedurally and factually defective. However, the Appellate Division disagreed, noting Lambertville had sufficient notice and many opportunities to be heard. It was noted Lambertville’s failure to comply with the judge’s requests led to the order. As for the motion to strike, the Appellate Division indicated Lambertville failed to oppose the motion, which provided the judge with the ability to decide without a hearing for an uncontested motion. Ultimately, the Appellate Division found no abuse of discretion and affirmed the judge’s rulings and order.

Result

No-Cause Jury Verdict Secured in Wrongful Death Trial

We successfully obtained a no-cause jury verdict in a 13-day wrongful death trial. The decedent, a 59-year-old man, was admitted to the emergency room on February 15, 2019, with complaints of abdominal pain, decreased appetite, and constipation, despite the use of laxatives. The patient did not complain of any nausea, vomiting, or diarrhea. He had a significant medical history including diabetes, hypertension, prior coronary artery stenting, morbid obesity (with past gastric bypass surgery), longstanding ventral hernia, and back pain. A CT scan revealed multiple hernias and a potential closed-loop bowel obstruction, leading to a surgery consultation. Our client, an emergency general surgeon, interpreted that the patient did not have a closed loop or any significant obstruction and recommended non-surgical management. The patient was approved to have clear liquids, and had a vomiting incident shortly after, but our client was not notified. The patient was returned to NPO status, and after improving overnight, he was returned to “clears” and additional medical and renal consults were ordered. Our client did not receive any communications from the residents/nurses of any changes in the patient’s condition. On February 18, 2019, two rapid responses were called due to increased heart rate and vomiting. It is believed that the vomiting resulted in aspiration, causing sepsis, ultimately leading to the patient’s death. During the trial, the plaintiff’s sole medical expert highlighted imaging on the wrong hernia, which called into question all of his opinions in the case. We made key objections related to the expert testimony, limiting what the allegations were, and preventing new allegations from being made. After approximately two and a half hours of deliberating, the jury returned a no-cause verdict.