Appeals Court of Massachusetts Upholds Decision Based on Opinion Independent Medical Examiner

In a recent Massachusetts workers’ compensation case, the Appeals Court of Massachusetts issued a ruling on the propriety of an appellate panel reversing a commissioner’s decision in a complex medical case regarding whether continued disability benefits were proper.

In the opinion, In Re Villiard’s Case, Mass. App. Ct. (2014), the employee Villiard worked as an insulation specialist for the employer for 18 years. His duties included installing attic insulation, drilling holes into the sides of buildings, and removing vinyl. The job duties required him to lift heavy objects, climb ladders, and crawl through tight spaces. On the day of the incident, Villiard injured his back while carrying heavy tubes up a flight of stairs.

Villiard sought treatment, and the doctor diagnosed a herniated disk and prescribed medication, physical therapy, and cortisone shots. The insurer accepted workers’ compensation liability but disputed the extent of his disability and its cause. Therefore, several months following the incident, the insurer filed a complaint to modify or discontinue the workers’ compensation benefits. Following a statutorily mandated conference, the complaint was denied, and so the insurer appealed to a de novo hearing.

An impartial medical examiner performed an evaluation, subsequent to Mass. G. L. c. 152, § 11A, and stated in his report that Villiard was no longer impaired, and that he could return to work without restriction. He further stated his opinion that any ongoing symptoms were “secondary to ongoing wear and tear degeneration in the lumbar spine which was not accelerated or aggravated by the alleged work injury.” Villiard motioned to have additional evidence allowed, due to the complexity of the medical issues involved. The administrative judge allowed Villiard’s doctor’s report for a certain period of time, in order to supplement the other doctor’s report. The administrative judge chose to adopt Villiard’s doctor’s report and his testimony regarding his limitations, thus denying the insurer’s complaint in its entirety.

The insurer appealed, claiming that the reliance on the other doctor’s report was in error, and the appellate panel agreed, finding that the independent medical examiner’s report was prima facie evidence regarding Villiard’s capacity to work, and that the benefits should no longer be paid. In his appeal, Villiard claimed that the decision should have been remanded, so that the decision could be revisited in light of the appellate court’s finding that the reliance on his doctor’s report was improper.

The issue on appeal thus was whether the board’s decision not to remand the case was an error of law, arbitrary or capricious, or an abuse of discretion.The court ruled that it was not. The board fully explained its reasons for the decision, which it found were amply supported by the evidentiary record. Therefore, it was within their discretion not to remand, and Villiard does not have further recourse on appeal. The judgment was affirmed.

If you become injured at work, especially if you have a preexisting injury, you’ll want to make sure that you’re represented by a workers’ compensation lawyer. The experienced Massachusetts workers’ compensation lawyers at Pulgini & Norton offer comprehensive guidance and representation in these matters. We will assist you throughout the entire workers’ compensation claim process. Call our office today at (781) 843-2200, or you can contact us online in order to schedule an initial consultation.

More Blog Posts:
Massachusetts Court of Appeals Discontinues Workers’ Compensation in Decades-Old Case, Massachusetts Workers’ Compensation Lawyer Blog, published February 25, 2015

Massachusetts Workers’ Compensation Law and Intentional Infliction of Emotional Distress, Massachusetts Workers’ Compensation Lawyer Blog, published February 18, 2015

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