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Knell O’Connor Danielewicz Workers’ Compensation Case Result

Case Name:  James Tucci v. Cannon Roofing / OBRC Construction

IWCC No.:  07 WC 050820

Venue:  Chicago – Arbitrator Carlson

Respondent’s Attorney:  Bradley C. Knell

Petitioner’s Attorney:  Sam Ruffolo


ISSUE: Can a Petitioner get away with blatant fraud when his employer and coworkers band together to testify credibly against an unwitnessed accident?

ANSWER:    No, at least not in this case.  Arbitrator Carlson found the Petitioner’s repeatedly conflicted explanations of his mechanism of injury and lack of actual injuries to be “staged” and “fraudulent,” therefore awarding him zero benefits under the Act after adopting the credible and accurate testimony of the employer, site manager, foreman, and coworker.

FACTS:   During the course of a 19(b) proceeding which began in March 2008 and ended August 14, 2008, Petitioner maintained he tripped and fell backwards off a 12 foot roof while working for ORBC Construction.

Petitioner repeatedly testified to impossible mechanisms of injury, which Arbitrator Carlson noted were “incredible and makes no common sense.”  Petitioner testified to various events leading up to the actual accident which Arbitrator Carlson noted were consistently contradicted by the credible testimony of his co-workers, boss, foreman, and employer.  Further, Respondent proved that it was phyiscally impossible for the Petitioner to suffer a fall as he testified.  In addition, surveillance testimony showed the Petitioner was able to move about without restrictions.  On the second day of surveillance, the Petitioner dressed up as a woman while cleaning snow off his truck and testified at trial “that was my wife.”  Fortunately, the Arbitrator did not buy into this.  To say the least, Petitioner was a bad cross-dresser.

Petitioner alleged he sustained a back injury as a result of the accident, however, Arbitrator Carlson repeatedly cited the fact that Petitioner presented no objective medical evidence indicating he sustained any injuries as a result of a traumatic fall.  Arbitrator Carlson noted there was “no evidence of bruising, swelling, contusion, or redness” anywhere on Petitioner’s body in the ER following the accident or subsequent treatment.

In determining the mechanism of injury to be too inconsistent to find an accident actually occurred, and opining that Petitioner attempted to perpetrate a fraud upon the Court, Arbitrator Carlson also found no causal connection between the alleged injuries and Petitioner’s employment after discounting the opinion of Petitioner’s treating physician, Dr. Koutsky, who found causal connection.  The Arbitrator found that while Petitioner’s history of injury was “ludicrous,” he was required to discount the opinion of the treating physician by noting Petitioner treated with him on a single date and finding “it would be difficult to imagine any reasonable physician to make such an opinion given the dubious circumstances.”

SIGNIFICANCE AND LESSONS:    While it may not always seem that way, the Arbitrators occasionally take note of blatant frauds upon the Worker’s Compensation system.  In this opinion, Arbitrator Carlson found that  the testimony and medical records clearly pointed to a “staged” accident and attempt at perpetrating fraud upon the system.  Arbitrator Carlson’s finding of fraud is a first for our firm.  Usually, the Arbitrators will simply find “the Petitioner is not credible.”  We believe now we can utilize this direct finding and apply it to a civil fraud action under the Illinois Insurance Fraud Act.

We believe this case is a firm example of what happens when the employer and his attorneys work together to point out the inconsistencies and incredulousness of some Petitioner’s alleged mechanisms of injury.  Without the help and testimony of the owner, site manager, foreman, and coworker of Petitioner, we do not believe this case would have been such a clear-cut victory for Respondent’s.  Through the hard work of all those involved in this trial, Knell O’Connor Danielewicz was able to clearly demonstrate to the Arbitrator the events described by Petitioner were blatantly false, inconsistent, and ludicrous.  We expect an appeal will be filed by Petitioner.