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Massachusetts Workers’ Compensation Benefits for Specific Injuries Limited on Appeal

In a newly issued decision concerning workers’ compensation benefits, the Massachusetts Reviewing Board of Industrial Accidents determined whether § 36 benefits were appropriately awarded to an employee after his employer’s insurer appealed the decision. In Scott Marino v. Progression Systems (April 5, 2016), the employee was injured in a catastrophic accident while on a business trip outside the country, when the car in which he was a passenger rolled over. The employee was rendered tetraplegic and confined to a wheelchair, receiving a long course of physical and occupational therapy.wheelchair-1178247-639x452(1)

The employee filed a claim for § 13, § 30, and § 36 benefits under the Massachusetts Workers’ Compensation Act. He was awarded § 36 benefits in the amount of $297,661.79, which included $25,344 for scarring and disfigurement, as well as reimbursement for medications, mileage, and parking. The administrative judge also ordered the insurer to pay for 24-hour nursing care, seven days a week. The insurer appealed, contending that the § 36 award exceed the maximum allowable amount of $15,000 for scarring and disfigurement, among other arguments. Specifically, the insurer argued the judge erred by including payments for $10,344 for scarring in addition to $15,000 for use of a wheelchair in violation of § 36(1)(k).

Pursuant to MGLA 152 § § 36(1)(k), an employee shall be paid for specific injuries, including bodily disfigurement, in an amount that is a proper and equitable compensation, not to exceed $15,000. However, no amount is payable for disfigurement that is purely scar-based, unless such disfigurement is on the face, neck, or hands. In interpreting the statute, the Reviewing Board held that the $15,000 limitation applies to all bodily disfigurements, both scar and non-scar based, resulting from a single injury. Therefore, the Board reversed the award of $25,344, finding that the insurer’s liability was limited to $15,000 for both the employee’s use of a wheelchair and scarring.

In addition, the Reviewing Board found that the administrative judge erred by failing to consider the maintenance and licensing costs of the employee’s handicap-equipped van. Although the provision of a motorized, specially equipped handicap van is required to be covered by the insurer, pursuant to § 30, the insurer is not responsible for the vehicle’s general maintenance or other ownership expenses. The Board therefore remanded the case for findings on which expenses were incurred by the employee for the van’s maintenance and ownership costs, including the cost of licensing. Accordingly, the order of the administrative judge was vacated with respect to the § 36(1)(k) benefits, and the case was recommitted for further findings consistent with the Board’s decision.

Injuries that arise from work-related conditions or as the result of an on-the-job accident may be covered under the Massachusetts Workers’ Compensation Act. If you have question regarding your benefits, seeking professional advice may be beneficial. At the Massachusetts firm of Pulgini & Norton, our injury lawyers are dedicated to assisting individuals with claims involving workers’ compensation benefits, and we can help you pursue medical expenses and lost wages. To discuss your claim with one of our skilled attorneys, contact our office at (781) 843-2200 or online and schedule a free consultation.

More Blog Posts:

Reviewing Board Addresses Evidence of Pre-Existing Condition in Massachusetts Workers’ Compensation Appeal, Massachusetts Workers’ Compensation Lawyer Blog, published January 27, 2016

Massachusetts Employee Prevails on Claim for Workers’ Compensation Partial Incapacity Benefits, Massachusetts Workers’ Compensation Lawyer Blog, published March 24, 2016

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