Oftentimes the C‑3 is overlooked as a possible tool to use against the claimant, but there are a few ways the C‑3 can be used to bolster a few major defenses, including violation of Workers’ Compensation Law Section 114(a).
First, a C‑3 can be used during the initial investigation of the file. If at the time of the initial investigation of the claim, a C-3 has not yet been submitted, it is recommended that a recorded statement of the claimant be obtained detailing the specifics of the alleged injury, including the mechanism of injury, body parts injured, prior accidents, notice, and the like. Once a C‑3 is later submitted, the C‑3 can be compared against the initial investigation, including the recorded statement given by the claimant. Should there be any discrepancy between the claimant’s recorded statements/written statement and the information provided in the C‑3, there is a valid basis to raise violation of Workers’ Compensation Law Section 114-a based on the claimant’s misrepresentation of material information. Also, any discrepancies can be a further red flag to perform additional investigation of the claim and raise appropriate defenses based on the outcome of the investigation.
A second useful way the C‑3 can be used is to litigate violation of WCL Section 114-a and fraud. Often, it is forgotten that any misrepresentation of a material fact in the claim is a basis to raise violation of WCL Section 114-a. One of the common ways a claimant may misrepresent a material fact is through the history of the alleged accident. The C-3 can be an important tool to use to determine any inconsistencies provided regarding the mechanism of injury as compared to the history provided to the claimant’s treating physicians. For instance, the claimant may provide a history of how the accident occurred and the body parts injured but later change that history when relaying how the accident occurred to their treating providers and IME’s. Inconsistencies in the mechanics of an injury as noted on the C‑3 as compared with prior statements to treating providers, including an IME, can certainly be used as a basis to pursue a violation of WCL Section 114-a. Also any inconsistencies can be used as a basis to challenge causal relationship of additional sites of injuries by way of an IME cover letter and later cross-examination of claimant’s treating providers.
Another useful defense of the C-3 is to investigate any prior conditions/accidents. Many times, the claimant will check off “No” when asked under Section F, #5, “Do you remember having another injury to the same body part or similar illness?” However, upon later investigation of the file it is discovered that the claimant did have prior injuries and failed to disclose the same. Since the C‑3 bears the claimant’s signature and is executed by the claimant, all representations made within the C‑3, including statements denying any prior injuries, are representations which can be used to pursue legal defenses and a potential fraud claim.
In summary, while the C‑3 may not be dispositive of all allegations made by a claimant or in a Section 114-a fraud claim by itself, it can be a useful guide for performing additional investigation and raising important legal defenses.