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Massachusetts Appeals Court Denies Employee Total Incapacity Benefits in Workers’ Compensation Case

A recent opinion released by the Appeals Court of Massachusetts, In re Driscoll’s Case, affirmed the decision of an administrative judge denying ongoing total incapacity benefits to an employee. The workers’ compensation case arose out of the employee’s claim that he suffered a work-related back injury in 2003. The self-insured employer had paid weekly incapacity benefits to the employee from July 22, 2003 through September 26, 2003. The employer, however, refused to pay the employee’s claim for ongoing benefits past that date.medic-alert-bracelet-1316095-639x412

At a hearing in front of the administrative judge, the employee, doctors, and an impartial medical examiner testified. Adopting the opinion of the impartial medical examiner, the administrative judge awarded medical benefits pursuant to G.L. c. 152 § 30 and total incapacity benefits under G.L. c. 152 § 34 to the employee through April 1, 2004.  The employee appealed that decision, seeking ongoing benefits past that date. The Department of Industrial Accidents reviewing board affirmed the administrative judge’s decision, and the employee appealed to the Appeals Court of Massachusetts.

In determining whether to continue total incapacity benefits, an administrative judge must decide whether the employee is so incapacitated as to render him unable to return to work. The employee’s primary argument on appeal was that the administrative judge erred by crediting only some of the medical opinions from doctors and not others, namely, the employee’s testimony and the testimony of his doctors. The court responded that credibility determinations are solely within the province of the administrative judge. The appeals court also recognized that the reason the employee’s testimony was discounted was because the administrative judge determined that it was unreliable and found that it contained misrepresentations regarding his physical limitations and level of activity after the injury. Furthermore, since the employee had misrepresented his symptoms to his doctors, the administrative judge was unable to rely on their medical opinions that the employee was disabled.

The employee also argued that the administrative judge erred by excluding the employee’s previous work-related injuries from the causation analysis. The court noted, however, that the administrative judge did find that the employee had a job-related disability, but it had ended by April 2, 2004. In addition, based on evidence that the employee was in fact working but had informed his doctors that he was not, the administrative judge properly considered that his attempts to work indicated that his disability had ended. The Appeals Court of Massachusetts concluded by affirming the decisions of the administrative judge and the reviewing board.

If you have been hurt while working on the job, you may be entitled to compensation for your injury, including medical expenses and lost wages. At the Massachusetts firm of Pulgini & Norton, our dedicated workplace accident attorneys represent and advise clients pursuing workers’ compensation benefits. To discuss your claim with one of our knowledgeable attorneys, contact our office at (781) 843-2200 or online to schedule a consultation.

More Blog Posts:

Massachusetts Appeals Court Finds for Worker Claiming Partial Incapacity Benefits, Massachusetts Workers’ Compensation Lawyer Blog, published August 12, 2015

Massachusetts Appeals Court Rules Against Injured Worker, Discontinues Temporary Total Incapacity Benefits, Massachusetts Workers’ Compensation Lawyer Blog, published July 29, 2015

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