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Man Without LegIf you were hurt on the job, the Massachusetts workers’ compensation system is designed to provide you with benefit payments and reimbursement for your medical expenses. This sounds relatively straightforward, but the claims process can be long and complicated, especially if your injuries are complex. One of the biggest issues that our seasoned Boston work injury lawyers encounter has to do with whether or not medical treatment will be reimbursable.

This issue was discussed in a recent decision from the Massachusetts Department of Industrial Accidents. In the claim, the injured worker and the employer’s insurance carrier filed appeals after the judge denied and dismissed the worker’s claim for insurance coverage for the costs of his long-term care. The order also required the insurer to reimburse certain costs of allocating a guardianship for the worker’s property and person.

The worker suffered an injury while he was employed as a custodian and working on a hot tar roof. The worker claimed that he suffered blisters all over his left foot and burns. Although the employee was treated promptly, he suffered ulcers, ongoing infections, and other conditions in his left foot. The worker filed a claim for workers’ compensation benefits, and the judge awarded the worker temporary incapacity benefits for his foot injury as well as his depression.

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woman in bedUnderstanding your rights after suffering an accident on the job can be overwhelming and confusing. This is especially true if you suffered serious injuries that may jeopardize your ability to return to work for a substantial period of time, or that leave you paralyzed. As Boston workers’ compensation lawyers, we have assisted numerous individuals with ensuring that they receive the maximum amount of compensation that they are entitled to obtain after being hurt on the job. One of the most critical aspects of a claim involves undergoing an independent medical examination. During this examination, the doctors will assess whether or not you are able to return to work. Being deemed capable of returning to work, even in a light duty capacity, can have serious consequences for your ability to receive benefits.

In a recent appellate opinion, the Massachusetts Department of Industrial Accidents considered a case involving a 63-year-old personal care assistant who was injured when she was helping a bedridden client. The woman described the pain that she suffered as a knife-like pain in her lower back that radiated to her left leg and foot. The woman ceased working and filed a workers’ compensation claim. She was awarded temporary incapacity benefits by her employer’s insurance company.

During an impartial exam, the reviewing physician diagnosed the woman with a chronic lumbar strain that also caused left leg radiculopathy and a degenerative spine condition. Both the employee and the insurance company agreed that the woman was no longer able to perform her job duties as a personal care assistant. The woman then underwent a series of medical treatments that eventually allowed her to be cleared for light duty work. The doctor later changed this finding to reflect that the woman was unable to work.

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Massaging Left ShoulderOne of the most complex aspects of any workers’ compensation claim is dealing with insurance companies, especially when multiple insurers are involved. At Pulgini & Norton, our seasoned team of Massachusetts workers’ compensation lawyers proudly provides legal counsel to injured workers and assists them with ensuring that insurance companies play by the rules.

In a recent opinion, the Massachusetts Department of Industrial Accidents considered a situation in which the first insurer to provide benefits on a claim argued that a subsequent insurer should be liable for paying an injured worker’s claim. The worker was employed as a certified nursing assistant when she suffered injuries after falling down a set of stairs on the job. The first insurer paid total incapacity benefits to the employee, and the worker underwent treatment for her left shoulder injury.

Some time thereafter, the woman reported pain in her right shoulder. The first insurer eventually stopped paying benefits, and the woman stopped working. She was later hired as a certified nursing assistant for a different employer until she left the position to undergo surgery on her left shoulder. While the woman was employed in this second position, she also provided some assistance privately to an independent senior individual. She claimed that he did not require significant assistance. The woman was not able to continue her employment as a certified nursing assistant because she found the job to be beyond her capabilities.

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Empty Hospital RoomIn a workers’ compensation claim, there are many rules regarding the types of evidence that the administrative law judge can consider when determining whether an award of benefits is proper. As seasoned Boston workers’ compensation lawyers, we are well-versed in these laws and fight vigorously to make sure that our clients receive the fair treatment they deserve during the claims process. If you were hurt at work, contact us today to learn more about whether you are entitled to workers’ compensation benefits.

A recent claim discussed the evidence that a judge may consider during administrative hearings. The employee in the action worked as a mental health care provider for patients suffering from psychiatric injuries. During May 2015, he was attacked by a patient and suffered serious trauma to his neck and the back of his head. He also sustained an injury to his left ear.

The employee filed a claim for workers’ compensation benefits with his employer’s insurance carrier. Pursuant to Massachusetts law, the employee underwent a medical examination by an impartial physician who assessed the nature and extent of his injury. The physician who performed this assessment testified at a hearing about the claim, and the judge concluded that the case involved medically complex issues. In instances in which there are medical complexities involved, a judge can allow the parties to provide additional medical evidence to assist with finding clarity. After this holding, the insurance company provided additional medical reports. These reports were not listed in the judge’s final decision or included in the list of evidence used in reaching the final decision.

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scientists in labThe Massachusetts workers’ compensation system provides benefits to individuals who suffer injuries on the job. For many individuals, knowing how to navigate the legal system and understanding the complex procedures that must be followed can be daunting. At Pulgini & Norton, our seasoned Boston work injury lawyers have assisted many workers with understanding the best way to assert their rights following an accident at work.

In a recent claim, the employee worked for a temp agency that sent him to work for a company testing new medications. The employee had a medical degree and experience working as a clinical researcher. His boss at the job site instructed him to duplicate her research for the purposes of validating her findings. After performing the same research and testings, the employee concluded that the doctor had used improper methodologies and that her findings were invalid. According to him, his boss pressured him to change his approach to mirror her original findings, but he refused. The employee alleged that his boss became unhappy with him and assigned him menial tasks as retaliation and that his co-workers ridiculed him. He was fired in July 2011. The employee alleged that he suffered emotional harm as a result of the professional disagreement with his boss regarding the appropriate way to test the medications.

The worker did not undergo any psychological treatment until roughly three years after he was fired. According to the psychologist, the employee suffered from a single episode of depression of a severe nature. An impartial medical doctor assigned to evaluate the man’s condition concluded that the man suffered from a schizoaffective disorder that was not related to the workplace events. Instead, this doctor concluded that the workplace events exacerbated the condition. The independent doctor determined that the man was completely disabled and that he was unlikely to experience an improved function.

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hand with magnifierThe United States Bureau of Labor Statistics collects information about many aspects of our workforce, including the rate at which workers suffer injuries and fatalities. Recently, the Bureau released a report that summarizes its findings regarding the number of fatal illnesses and workplace injuries that occurred during 2016. The results of this report are startling and highlight what we as experienced Boston workers’ compensation lawyers already know:  Massachusetts workers face serious risks of injuries and must protect themselves at every opportunity.

According to the report, there were over 5,000 employees who lost their lives as results of accidents at the workplace during 2016. This constituted the highest number of fatal accidents since 2008. This is particularly staggering considering the increased efforts from the federal Occupational Safety and Health Administration to improve safety conditions in workplaces throughout the country. Many state and local agencies have also increased their efforts to make sure that employers are providing safe working conditions and complying with safety laws.

The report pinpointed traffic accidents as the primary reason that workers lose their lives on the job. In a bustling city like Boston, the odds that an employee will be involved in a crash are likely higher due to the heavy traffic and high population. Violence in the workplace was the next most significant cause of fatalities for workers, followed by falls. Contact with equipment and objects was the next highest category. Finally, the Bureau listed encounters with dangerous chemicals and substances as a major cause of deaths.

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empty officeMany individuals have pre-existing injuries with which they cope on a daily basis. When it comes to suffering an injury on the job, these existing injuries can lead to complications and delays when it comes to ensuring that you receive the compensation that you deserve. At Pulgini & Norton, our Boston workers’ compensation lawyers have assisted many injured employees with asserting their right to benefits vigorously and efficiently.

In a recent workers’ compensation case, the injured worker performed administrative duties for his employer. In some instances, he was also required to restrain youths who were acting aggressively or in a violent manner. During one situation in April 2009, the employee suffered an injury to his shoulder and lower back while he was trying to stop an incident between two teenagers. He filed a claim for workers’ compensation benefits.

Before a hearing on his claim, he underwent an examination by an impartial doctor according to Massachusetts law. The man also had to undergo an operation to address his injury. The doctor who examined him and two surgeons who performed the operation were deposed prior to the hearing. He also underwent an exam performed by another physician at the behest of the employer’s insurance carrier. This doctor prepared a report that was admitted into evidence for the hearing.

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picture of spineIn a workers’ compensation claim, medical experts are often used to help the administrative law judge determine many aspects of the issues involved, including the nature of the employee’s injury, whether the injury was completely a result of the worker’s job duties, and whether the condition will resolve over time. At Pulgini & Norton, our experienced team of Massachusetts workers’ compensation lawyers has handled numerous claims on behalf of injured workers and assisted them with ensuring that they receive the maximum amount of benefits that they deserve.

In a recent appellate opinion, the court discussed administrative law judges’ ability to rely on and adopt a medical expert’s opinion. The worker in the case was a man in his 50s working as a laborer with heavy equipment for the City of Pittsfield. The man claimed that he suffered a back injury while operating road equipment during 2008. Roughly one year later, he suffered another work-related injury. In 2012, he underwent a spinal surgery procedure.

The man then had an examination with a neutral medical doctor, but the administrative law judge ruled the exam insufficient due to the complexity of the medical issues involved. Sometime thereafter, the employer accepted liability for the second injury but claimed it stemmed from a pre-existing injury and other medical conditions. After another hearing, the administrative law judge concluded that all of the man’s injuries were related to his workplace activities. The employer was ordered to pay benefits to the man as a result.

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case of moneyEmployers have a legal responsibility to abide by Massachusetts workers’ compensation laws. Despite these clear mandates, many employers try to cut corners or to bend the rules to avoid having to pay for workers’ compensation benefits in the event that an employee becomes injured. The Massachusetts workers’ compensation lawyers at Pulgini & Norton have guided numerous injured workers through the claims process while helping them ensure that they are treated fairly by employers and insurers alike. According to a report produced within the last five years, the Massachusetts Insurance Fraud Bureau (MIFB) concluded that a wide number of employers misreport the number of workers that they have in their employment, or misclassify an employee to reduce the requirements that they must meet for workers’ compensation premiums. The report also shows that employers typically are quick to revise their classification in the event that one of the previously misclassified employees suffers an injury.

This report is not alone in its findings. The Massachusetts Department of Industrial Accidents researched employers’ use of misclassifications and found that as many as 250,000 workers are not classified appropriately by employers. It also found that roughly 13 percent of employers in Massachusetts engage in some type of misclassification. During 2013, there were roughly 6,000 business operations that were investigated regarding their workers’ compensation compliance and insurance coverage. As a result of these investigations, over one-third of the businesses involved were mandated to cease operations, and a total of $1.3 million in fines were assessed against non-compliant employers. Also, employers involved in the investigations added 6,000 or more employees to workers’ compensation insurance policies.

Harvard Law School has also investigated this issue. It concluded that 15 percent of workers in the construction industry are improperly classified as independent contractors. The employers list them as non-employees to prevent having to pay workers’ compensation benefits in the event that the worker becomes injured. Additionally, many employers do not provide accurate information about the risks that their workers face on a daily basis. This is in an effort to prevent having to pay higher premiums for workers’ compensation insurance. The MIFB conducted investigations of almost 400 allegations of insurance fraud and determined that in 10 percent of those cases, the employer was not complying with the regulations. The investigation resulted in convictions of seven individuals and restitution in the amount of $300,000. In the same time period, a Massachusetts task force amassed in excess of $21 million in missed tax income that resulted from employers’ failures to follow the rules.

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people in stableWhen you are injured at work and deemed eligible for benefit payments, you have the option of requesting a lump sum settlement instead of weekly or periodic payments. This is a decision that should not be taken lightly. As experienced Massachusetts workers’ compensation lawyers, we have guided many injured workers through the claims process and helped them determine a strategy to maximize their recovery.

In a recent appellate opinion, the court considered whether accepting a lump sum payment affects the injured employee’s ability to appeal the amount of benefits awarded to the employee. The employee in the case was a materials handler who suffered an injury to his left arm while working. After filing a workers’ compensation claim with his employer’s insurer, the man received weekly benefit payments based on a $400 average weekly wage for a specific period of time. During the next four years, the employee changed jobs many times and eventually took work at a stable. He also claimed that his prior work injury still caused him pain. He did not suffer a new workplace injury but instead sought medical treatment. He eventually ceased working and did not return to work as a result of the pain he was experiencing. When he ceased working, his average weekly wage was determined to be $265. The worker filed a new claim for benefits, and the original insurer that provided benefit payments joined the action. The insurer claimed that the new job that the worker held created the basis for a new work injury.

The employee underwent a neutral examination by a doctor, and the doctor’s report was admitted as evidence in the new claim. The parties were also allowed to submit additional evidence, due to the complex medical issues in the case. Considering the report and the parties’ evidence, the judge concluded that while the employee was totally disabled at first, he was now capable of performing light-duty work. Based on this, he was awarded total disability benefits from the date that he ceased working and ongoing. The judge also determined that the man could earn roughly $64 per week and that his average weekly wage was $265. At the conclusion of this hearing, the worker requested a lump sum settlement from the insurer. He then filed an appeal.

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