Articles Posted in Workers’ Compensation

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ladder on buildingMassachusetts statutes provide a specific, formulaic approach to calculating the amount of weekly benefit payments that an injured employee is entitled to receive. This calculation is based largely on the injured employee’s average weekly wage. A key component of any workers’ compensation claim is ensuring that you provide enough information for the claims adjuster to calculate your average weekly wage so that you receive the maximum amount of benefits to which you are entitled. As Massachusetts workers’ compensation lawyers, we have assisted many victims with protecting their rights and securing compensation. As a recent case demonstrates, having a knowledgeable attorney on your side can prevent delays in your claim.

The claimant was injured on the job when he fell from a ladder. The claimant was painting the side of a building in Springfield, Massachusetts when the accident occurred. He notified his employer, which filed a claim for workers’ compensation benefits with its insurer. An administrative law judge reviewed the claim and concluded that the claimant was entitled to receive total incapacity benefits. The ALJ also noted, however, that there was insufficient information regarding his average weekly wage.

At a hearing on the issue, the claimant indicated that he had entered into an agreement to receive roughly $1,000 from the employer to paint the home. He also indicated that he fell from the ladder on the second day of working on the project. The employer fired the man on the day after his injury and paid him $500. He also testified that he earned roughly $8,000 in the prior year for his work painting homes and that he also performed a variety of other employment occupations. Based on this evidence, the ALJ concluded that the claimant was performing seasonal work at the time he fell from the ladder. Since calculating an average weekly wage involves dividing the claimant’s earnings by 52 weeks, the ALJ concluded that his average weekly wage was $150.

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empty courtroom settingOne of the most daunting aspects of a workers’ compensation claim is ensuring that you do not make any procedural errors early in the process that will have an impact on your ability to recover benefits. Consulting a seasoned Massachusetts workers’ compensation lawyer early in the process is one of the best ways to avoid the headaches that can arise from procedural mistakes, as the following recent claim demonstrates.

The claimant alleged that she suffered an injury to her back while working in December 2003. She notified her employer, which initiated a workers’ compensation claim with its insurance carrier. The carrier denied the claim, and the claimant appealed. An administrative law judge upheld the denial of medical benefits and incapacity benefits at the appeal hearing. After an additional series of appeals, the case made its way to the Court of Appeals of Massachusetts. This court affirmed the ALJ’s ruling denying benefit payments to the claimant.

In the years that followed, the claimant continued to assert claims seeking incapacity benefits regarding the 2003 injury. In each instance, the claim was withdrawn after the ALJ concluded that it was precluded based on a legal principle known as res judicata. This widely recognized legal principle holds that a matter cannot be revisited after a final judgment has been rendered after considering the merits of the action.

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empty witness boxSince workers’ compensation claims involve medical conditions and injuries, the consideration of testimony from treating physicians plays a pivotal role in determining whether an employee is entitled to workers’ compensation benefits and how long these payments should continue. As seasoned Massachusetts work injury lawyers, we know just how critical medical expert testimony can be in your claim. A recent case demonstrates how problematic conflicting medical testimony can be for a claimant.

The claimant alleged that he suffered injuries to his back when he was lifting a piece of equipment while working. The man said that he required back surgery and that he did not return to his usual occupation afterward. After a workers’ compensation claim was initiated, the employer accepted liability and paid total disability benefits to the employee from the day that the injury occurred forward.

Three years later, an ALJ denied a request from the employer to lower the weekly benefit payment amounts. Shortly thereafter, the claimant filed a claim seeking permanent and total incapacity benefits pursuant to § 34A. In response to this petition, the employer asked the court to issue an order alleviating it from paying any and all future benefit payments to its former employee.

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large snow plowOne of the most common issues that we come across as Massachusetts workers’ compensation attorneys is claims involving injured workers who have pre-existing conditions. Depending on the nature of your existing injury and your work-related injury, you may be allowed to recover benefit payments for the aggravation of a pre-existing injury. A recent workers’ compensation case highlights a number of issues involved with claims concerning a pre-existing injury.

The claimant worked at a car dealership as a salesman. As part of his responsibilities, he was required to clear snow from certain areas on the dealership property. During January 2009, the employee alleged that he suffered injuries while he was getting out of a snow plow machine. About 30 days later, he sought medical evaluation for a neck injury at the local medical facility. During this time, he continued to work as a salesman at the dealership until October 2009, at which time he quit.

Then, the man applied for workers’ compensation benefits regarding the neck injury that he sustained. He also included allegations regarding back pain. The employer refuted the claim, saying that it was not responsible for the neck injury or the back injury because the fall that occurred in January 2009 was not the sole cause of the overall injuries that he listed in the claim. Next, the employee underwent a medical examination by an impartial doctor, according to § 11A. Both parties submitted supplemental medical documents to the administrative law judge before a hearing was held on the employee’s claim.

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In a decision involving a claim for Massachusetts workers’ compensation benefits brought by an employee who suffered from a pre-existing medical condition, the Massachusetts Department of Industrial Accidents, Reviewing Board affirmed the administrative judge’s denial of benefits.  The Board focused on the judge’s determination that the employee’s injury had not been caused by work and specifically that his work-related tasks did not rise to the level of “repetitive” activity to have caused his disability.

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Before his injury, and for 11 years, the employee worked by brazing, welding, and feeding tubes of copper into machines that made hot water heater coils.  The employee stated he spent much time at work brazing or welding. In December 2011, after feeling pain in his right knee, the employee notified his supervisor and completed his shift. He did not return to work for six days and sought medical attention.

The employer provided testimony that the employee did not often do coiling work and that he had not reported an injury on the day of the alleged incident.  Additionally, the judge heard testimony from the employer’s plant supervisor, who stated that the employee’s physical restrictions described by his treating physician after the December 2011 alleged injury were not indicated to be work-related.

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Workers’ compensation benefits are provided to employees injured in the course and scope of employment, without requiring that they prove fault for an accident or a workplace medical condition.  This means that the employer need not have directly caused the injury to the worker.  Boston workers’ compensation claimants are entitled to benefits if they are considered “employees” at the time they suffered the injuries. For some claimants, determining their employment status is critical to their claim for benefits. Administrative judges look at a variety of factors in assessing whether workers are employees or independent contractors, in accordance with state law.worker

Massachusetts law defines “employee” in Chapter 152, Section 1. According to the definitions in this section, employees are those individuals who are hired under a contract to perform services for another party.  When an injured worker is an employee, rather than a contractor, they will be entitled to benefits and payments set forth under the Workers’ Compensation Act. In some cases, administrative judges must determine employment status as a main dispute in a workers’ compensation claim for benefits.

For workers’ compensation claimants in the Boston area, establishing their status as an employee, rather than a contractor, is essential to proving their entitlement to benefits.  Administrative law judges oversee workers’ compensation cases and rely on select criteria to ascertain whether workers are employees, according to the Act.  Factors that may be considered include whether a worker provided a service according to a contract, either written or oral.  In some cases, workers may sign contracts that make clear their status as contractors.  They may also inquire into whether workers have filed taxes as independent contractors.

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Injured workers, like others dealing with pain, may turn to painkillers such as OxyContin and Vicodin to alleviate their symptoms.  Throughout the nation, and particularly in Massachusetts, workers’ compensation systems are attempting to stop the overprescription of these powerful painkillers to workers.  This reflects an effort to help workers avoid addiction and potentially dire consequences, such as fatal overdoses.

Last year, Boston, along with the rest of the state, entered into a voluntary program to help injured workers who have settled their claims for Massachusetts workers’ compensation receive treatment for pain management. The intention of the program is to limit the use of opioids or other narcotics.  By coordinating chronic pain management options other than the use of prescription opioids, the chance of an injured worker becoming addicted to medication lessens.

Insurance companies for employers pay for prescription medications when injured workers receive workers’ compensation benefits for their injuries, and a prescription has been indicated as treatment. As employees pay into the workers’ compensation insurance systems, states are responsible for oversight of the insurer.  The insurance company is responsible for providing medical care and reimbursing wage loss to workers who have suffered work-related injuries and successfully filed a claim for benefits.

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The Health and Safety Act of 1970 makes clear that employers must provide all workers a safe place to work, free from potential hazards.  In a recent press release, the Department of Labor’s Occupational Safety and Health Administration (OSHA) determined that a Massachusetts company did not notify the agency, as was required, that a worker was hospitalized after suffering a serious injury.  This serious safety and health hazard was cofactorympounded by the fact that the employer also failed to notify emergency medical services promptly after the Massachusetts work injury.

This particular packaging company is responsible for filling, packaging, and shipping aerosol containers.  The injured worker had been working on a production line, and a gas head on this line directs chemicals into the aerosol cans. As a temporary worker, he was not sufficiently trained. At the time of the serious injury, the worker was cleaning a gas head. Unexpectedly, the production line activated.  The result was devastating – a gas head needle pierced the worker’s’ finger, injecting him with a propellant gas that then inflated his arm.

OSHA’s investigation revealed that company managers had not contacted 911 immediately.  The hurt worker was taken in a private vehicle for medical treatment and was hospitalized.  The OSHA area director for central and western Massachusetts made clear that according to law, employers should immediately contact 911 following an employee injury.  In this case, by delaying contact, the worker was exposed to additional bodily harm and potentially permanent, disabling injuries.

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A recent decision by the Massachusetts Department of Industrial Accidents, Review Board, held that an Administrative Judge’s decision awarding benefits to an injured employee must be recommitted and reassigned to a different judge, based on the judge’s misconceptions and mischaracterization of the medical evidence.  The Board agreed in this appeal with the self-insurer, who argued that the judge had adopted the mischaracterized evidence to support his findings and conclusions, despite the fact the evidence could not be reconciled with other evidence.wheelchair

The employee in this case worked for the Department of Corrections. After being struck in the face by a resident of the Department of Corrections, the Massachusetts workers’ compensation claimant in this case brought a claim against his employer for benefits.  He had received disciplinary action following the incident, since he had pushed the employee in his chair after being struck.

The Board stated that the judge had viewed the case as one involving a physical injury resulting in an emotional sequela.  Since the employee in this case had a pre-existing mental health issue, and this combined with the injury,  G.L. c. 152, § 1(7A) was triggered. This section of the law holds that for employees who have a pre-existing condition, a compensable injury that prolongs their need for treatment or disability will be compensable when the injury is a major but not predominant cause of the disability or need for treatment.

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Recently, the Reviewing Board for the Massachusetts Department of Industrial Accidents affirmed an award of benefits to an employee for her physical and psychiatric disabilities.  The Board made clear that this was a Massachusetts workers’ compensation case involving both orthopedic and psychiatric sequela, and therefore there was a causal connection between the employee’s injury and her depression.  The Board also reviewed legal rules that require that medical testimony be considered as a whole when determining the opinion being given.boot

The employee in this case slipped and fell at work, suffering multiple fractures in her foot.  The self-insurer paid workers’ compensation benefits related to this foot injury and to the psychiatric consequences of the injury.  After undergoing multiple surgeries to her left foot, the employee had testified that she still suffered pain and had difficulty with stairs.  According to the employee, she feels sad and cries often, due to her physical limitations and pain.

The judge had awarded the employee benefits based on his finding that she was permanently and totally disabled, both due to her orthopedic condition and due to her major depression caused by the work-related accident.  The self-insurer appealed.

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