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Workers’ Compensation Insurer Accepted Causation Between Work Injury and Death When Failing to Appeal Award of Burial Benefits to Spouse According to Massachusetts Law

In a Massachusetts Reviewing Board Decision, the Department of Industrial Accidents determined that the spouse of a deceased worker was entitled to burial benefits, although they affirmed the denial of her claim for dependency benefits.  The issue on appeal was whether the insurer had, by failing to appeal the award of burial benefits, established that causation existed (that the employee’s death was work-related).  The Board rejected the notion that burial benefits lack a causation element, and it held that by failing to appeal the order that awarded burial benefits, the insurer established that there was a causal relationship between the employee’s work-related injury and his death.

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The facts of the case indicate that the employee in this case worked for the Sheriff’s department as a caseworker, and he suffered back and neck injuries at work.  He was paid § 34 benefits until his death, caused by excessive aspirin ingestion.  At the time of his death, the employee was married but living apart from the claimant.

The claimant (spouse) filed a workers’ compensation claim for benefits based on dependency benefits and burial benefits provided by Massachusetts’ workers’ compensation laws.  At a hearing, the insurer argued the claimant was not entitled to those benefits, but the judge ordered that burial or funeral expenses be paid.  The judge denied the claim for dependency benefits, and the claimant appealed.

The focus of the claimant’s argument was that by not appealing the order that awarded her burial benefits, the insurer could not argue that there was no causation between the injury and the employee’s death.  Since, she argued, the judge awarded burial benefits, the employee’s death was work-related, and the insurer could not argue otherwise.  The remaining issues were whether she qualified as the employee’s dependent and the amount of the dependency benefits she sought.

The judge had agreed that when a conference order is not appealed, the parties are bound to all of the matters covered by the order.  On appeal, the insurer argued that the judge did not allow it to argue the issue of causation between the employee’s injury and his death.  But the Board rejected the argument that by denying the dependency benefits, the judge denied the causal relationship.  First, the Board stated, the judge ordered burial benefits, and second, a causal relationship is only one element of a dependency benefit claim.

The rule, stated by the Board, is that burial benefits may be awarded when a causal relationship exists between the employee’s injury and death.  In comparison, to be awarded dependency benefits, the claimant must show both causation as well as a dependency relationship. By failing to appeal the conference order, the insurer accepted the award of burial benefits.  The Board stated that the claimant appealed but did not carry the burden of proving the elements of her claim for burial benefits. Since causation is an integral element of burial benefits as well as dependency benefits, the judge barred litigating that issue at the hearing.

Next, the Board rejected the insurer’s argument that burial benefits are awarded in every case when an employee dies while indemnity benefits are being paid.  The Board stated that this cannot mean that causation is not an element of proving entitlement to burial benefits, since those employees who die from non-work related causes would not be entitled to burial benefits.

Turning to the context of policy, which provides employees with rights following work-related injuries, the Board noted that even burial benefits maintain a causation element.  By failing to appeal the award of burial benefits, the insurer accepted the causal relationship between the injured employee and his death.

The Board affirmed the decision in favor of the claimant.

The skilled workers’ compensation attorneys at Pulgini & Norton help individuals and families set forth their legal right to compensation and benefits for work-related injuries. To learn more about your claim, schedule a complimentary call with a dedicated attorney by calling (781) 843-2200.

More Blog Posts:

Massachusetts Review Board Finds Employee’s Lyme Disease Was Caused by Exposure During Work For First Employer; Causation Established and Closed Period Benefits Awarded, Massachusetts Workers’ Compensation Lawyer Blog, May 25, 2017

Massachusetts Reviewing Board Finds Harmful Error in Inconsistent Findings Regarding the Cause of Employee’s Psychological Harm, Massachusetts Workers’ Compensation Lawyer Blog, December 15, 2016

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