Articles Posted in Workers’ Compensation

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back painAlthough injured workers are entitled to benefits for injuries that happen on the job, there are some procedural rules and defenses that employers and insurance companies can use to avoid paying benefits. One of these rules is called the serious and willful conduct rule. As experienced Boston workers’ compensation lawyers, we have handled numerous cases that involve this issue.

The Massachusetts appellate court recently considered a claim involving the serious and willful conduct rule. The employee was 48 at the time the injury occurred and was an immigrant from Albania. He did not speak or write English and provided testimony in the proceedings through an interpreter. He worked as a truck driver starting in 2006 and was involved in a rollover accident while on the job in 2012. He underwent a spinal surgery following this accident and settled the associated workers’ compensation claim in 2014. The settlement agreement excluded the disc herniation procedure and only encompassed liability for soft tissue injuries in his lumbar region.

The man started working for another employee in 2015 and was shortly involved in another accident while driving a truck on the job that resulted in injury to his lower back. He was driving with a suspended license at the time of this accident. The administrative law judge assigned to the claim initially denied his request for benefits. The employee appealed seeking payment of benefits along with reimbursement for medical expenses. The Workers’ Compensation Trust Fund defended against the appeal asserting many different arguments, including an argument that the employee acted serious and willfully and was therefore barred from seeking benefits.

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wrist painIf you were injured on the job, you may be entitled to workers’ compensation benefits. There are many different steps that you must take in order to receive benefit payments. One of these steps includes an assessment of your injuries and a determination of the extent of your injury, i.e., whether it is total or partial and whether it is temporary or permanent. The evidence presented in support of this finding is critical and insurance companies often fight awards of benefits on the basis that there was not sufficient evidence to support the judge’s ruling. As determined Boston workers’ compensation lawyers, we will ensure that you are treated fairly during the claims process and that you receive the maximum amount of compensation possible.

A recent Massachusetts appellate opinion demonstrates a dispute about whether there was sufficient evidence to support an award of benefits. The employee was 53 years old at the time of the dispute and had an eighth-grade education. She worked for 19 years as a machine operator in a job that was repetitive, strenuous, and required constant use of both of her hands and arms. The machines she operated manufactured plastic buckets and lids. During 2015, she began experiencing numbness in her hands. She underwent surgeries in October and November of 2015. Although she tried to resume work in January 2016, she was sent home when she reported throbbing pain in her hands and numbness.

In the workers’ compensation claim, the judge concluded that she was experiencing bilateral carpal tunnel and awarded total incapacity benefits as well as compensation for medical expenses.

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speeding carWorkers’ compensation cases involving pre-existing medical or health conditions can be complicated. The law entitles an employee to receive compensation to the extent a work-related injury exacerbates the pre-existing injury. Ensuring that your pre-existing injury is diagnosed correctly and that you receive the full amount of benefits you deserve for the exacerbating work injury is critical. At Pulgini & Norton, our Boston workers’ compensation attorneys proudly help injured workers negotiate with insurance companies and fight for their rights.

The Massachusetts appellate court recently considered whether an award of benefits to an injured employee with a history of back conditions should be terminated based on a medical finding that he reached maximum medical improvement. The employee was hurt while working as a glass installer during a motor vehicle accident in August 2015. The insurer for the employer paid temporary total incapacity benefits. During November 2016, it filed a complaint to discontinue payment of benefits or modify those payments base don a report from an independent medical examiner. A judge reviewing the request ordered a modification of the benefit payments to partial incapacity benefits and determined that the employee’s earning capacity was $250 per week. Both parties filed an appeal and the employee underwent another independent medical examination.

Another hearing was held at which the judge concluded that the matter was medically complex and deemed the examiner’s report inadequate. The parties submitted additional medical evidence and the judge concluded that the employee had a history of lower back pain that’s not related to his occupation, including a spinal fusion that happened when he was eight. In addition to listing other back-related injuries that the employee suffered, the judge adopted medical opinions concluding that the employee experienced a flare-up of an existing back condition and that he returned to his pre-accident level of capacity. The judge also adopted an opinion finding that the employee reached maximum medical improvement and that any impairment was based on pre-existing conditions and not the work-related accident. The judge also concluded that any additional medical treatment would not be related to the accident and would be related to his pre-existing conditions.

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workers compA critical phase of any workers’ compensation claim is determining the extent of the disability and the date that the injury occurred. Having a tenacious Boston workers’ compensation lawyer to assist you with ensuring that the rules are being appropriately and fairly applied in your claim can make all the difference.

In a recent claim, the employee was a plumber who suffered an injury to his neck while sleeping in 2004 that required a surgical procedure. In 2008 or 2009, the employee left self-employment and worked for a plumbing company. In 2013, he reported stiffness in his neck after using a hammer drill for approximately one hour. He underwent treatment with a neurosurgeon and the employer paid section 34 benefits until April 5, 2014. The employee then filed a claim for section 34 benefits from April 6, 2014, and continuing. The judge ordered the employer to pay section 34 benefits from April 6, 2014, to August 25, 2014, and section 35 benefits from August 26, 2014, and continuing. Both parties filed an appeal and the employee modified his request to seek section 34 benefits from September 11, 2013, the date of the injury, and ongoing.

The employee underwent an independent medical examination with an orthopedic surgeon. The judge allowed the employer to submit additional medical evidence after concluding that the orthopedic surgeon’s report did not sufficiently describe the connection between the pre-existing neck injury and the work injury. The judge then concluded that the employee suffered an industrial injury and that accident was a major but not necessarily predominant cause of the injury and need for treatment. He ordered payment of weekly section 34 benefits from the date of the injury to January 5, 2015, and payment of section 35 benefits from that date and continuing.

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knee injuryIf you were injured at work, you may be entitled to benefits and reimbursement for your medical expenses. At Pulgini & Norton, we have helped countless Boston residents understand the Massachusetts workers’ compensation system while helping them secure the outcome that they deserve.

As a recent claim demonstrates, one of the most critical aspects of a claim is knowing when to assert certain defenses or objections. In the claim, the employee suffered an injury to her right knee while working as a registered nurse. She was unable to work for a period of time and underwent surgery to address the injury. She returned to work less than a year after the injury, but reported chronic pain and symptoms when she increased her activity. She left work again due to the pain and filed a claim for benefits. The insurance company accepted liability for her right knee injury and provided benefit payments.

The insurance company filed a motion to discontinue payment of benefits, which was denied. The insurer appealed and the employee underwent an independent medical examination for her right knee only. The parties then sought another independent medical examination that covered both knees to determine causation and the extent of her disability.  Medical evidence was presented at a hearing and both sides presented a vocational expert. The judge ultimately adopted the testimony and reports of the employer’s vocational expert, modified the employee’s benefits from section 34 to section 35 benefits, and ordered the insurer to pay for medical expenses associated with the right knee only.

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medical assessmentWhen an employee is injured on the job, he or she can submit a claim for workers’ compensation benefits. This provides compensation for missed wages as well as medical treatments that are reasonably related to the work injury. Unsurprisingly, many insurers will debate whether a medical treatment should be reimbursed, arguing that it was not a reasonable outcome of the accident. As dedicated Boston work injury lawyers, we have the skills and experience it takes to ensure that you are treated fairly.

Recently, a Massachusetts appellate court considered a claim in which an insurer argued that it should not be required to pay for certain treatments related to an injured workers’ spinal injury. The woman worked as a transporter and cleaner when she suffered an injury to her neck. She underwent several operations and treatments including multiple spinal fusions.

Eventually, the woman accepted a lump sum settlement for her neck injury. Next, she received a surgical treatment for her lower back. She then filed a claim seeking reimbursement for medical expenses to pay for a Duragesic patch that would treat her persistent neck pain. Before a hearing on the claim, the employer’s insurance carrier was paying for half of the cost of the patch. After the hearing, the judge ordered the insurer to keep paying for half of the cost of the patch but denied the woman’s claim for compensation for additional medical bills. Both parties filed on appeal.

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time limitIf you are injured on the job, it is important that you file your claim for workers’ compensation benefits within the appropriate time period. This is known as the statute of limitations. Determining when your right to benefits accrued and how long you have to assert your claim can be difficult. This is especially true where your injury is the result of ongoing or repetitive conduct, or where it involves a pre-existing injury. Our knowledgeable team of Boston work injury lawyers is prepared to assist you with investigating your claim and ensuring that you protect your rights during this stressful and painful situation.

A Massachusetts appellate court recently discussed the application of the statute of limitations doctrine in a work injury claim. The employee suffered an injury to his shoulder in 2004 that required him to eventually undergo surgery. He received benefits until he returned to work after the injury.

Four years later, the employee filed a claim for temporary total incapacity benefits as well as other benefits based on the 2004 injury. In the claim, he also requested that the insurer pay for a left shoulder surgery that his treating orthopedist recommended. The claim was denied and the employee appealed. He then underwent an impartial medical examination. The judge assigned to the matter retired while the claim was pending and a new judge was assigned who reviewed the matter de novo. The employee also suffered a second injury to his left shoulder in 2012 and filed a claim requesting medical benefits for this injury.

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Just like civil claims for compensation, the Massachusetts workers’ compensation system has statutes of limitations that dictate when an injured worker must file a claim in order to receive benefits. It can be difficult to know when your time may run out, which is why speaking with a Boston work injury lawyer about your situation is so critical. At Pulgini & Norton, we provide personalized and compassionate legal counsel to individuals throughout Massachusetts and are standing by to assist you with exploring your legal right to compensation after a work injury.doctor

A Massachusetts Court of Appeal recently considered an appeal regarding a challenge to whether the employee had filed her claim within the statute of limitations. The employee was working as a nurse at the time of the dispute. She suffered an injury to her neck in 2007 that required her to seek treatment at the emergency room. Although the employee continued working, her pain worsened, requiring her to undergo spinal surgeries. She was out of work for several months and later returned. Although she did not file a claim for workers’ compensation benefits, she received short-term disability benefit payments for the time that she was out of work. Her testimony also indicated that she did not report her work-related injury to her employer in 2007.

During 2009, the employee sought treatment for her neck injury and continued to work. During 2012, she reported being unable to turn her neck after what she described as a heavy assignment. She underwent treatment and was unable to work for three months. During this time, she once again collected short-term disability benefits.

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Although many people are aware that you can seek workers’ compensation benefits for a physical injury suffered on the job, many are unaware that the Massachusetts workers’ compensation system provides compensation for psychiatric injuries as well. If you believe that you suffered psychiatric harm as a result of your occupation, contact our seasoned legal team to start exploring your legal rights and options.Legal News Gavel

In a recent appeal, a Massachusetts court considered an insurer’s appeal of an award of benefits to a woman based on an injury she suffered to her foot. The woman fell while walking down a flight of stairs and underwent a number of surgeries on her foot that did not result in any measurable improvement. The employer’s insurer accepted liability and provided benefit payments. The woman reported experiencing many physical limitations and difficulties associated with her foot injury over the course of her four surgeries. She reported experiencing physical limitations that limited her daily activities, such as experiencing significant discomfort in the injured foot during severely cold weather. The woman testified that as a result of these physical limitations, she often felt sad and experienced fits of anger and depression.

The judge assigned to the claim ultimately concluded that the woman was permanently and totally disabled as a result of her physical injury as well as her depression stemming from the work-related injury. The judge awarded her the full amount of disability benefits to which she was legally entitled, and the insurer appealed.

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As seasoned Boston workers’ compensation lawyers, we know how important it is for injured workers to receive the medical treatment and reimbursements that they deserve in a timely fashion. Unfortunately, many workers’ compensation claims involve disputes with or among insurance companies regarding whether a treatment should be compensable, or which insurer should pay. One of the best things you can do when seeking workers’ compensation benefits is seeking experienced legal counsel to help avoid any delays or complications in your claim.Legal News Gavel

Recently, a Massachusetts court considered a conflict regarding which insurer was required to pay for an injured worker’s medical treatments. The worker was employed as a certified nursing assistant when she fell down a flight of stairs, suffering injuries to her knee and shoulder. The first insurer for the employer paid weekly total incapacity benefits to the employee. She received treatment for the injuries and reported experiencing pain. After 2008, she was unemployed and then secured a job with another nursing company. She was then required to leave work to undergo surgery on her shoulder. During this employment, she also performed some private assistance through a senior care service for an elderly gentleman who required minimal assistance.

After the surgery, the woman reported not experiencing any significant improvements. She filed a claim against the first insurer, seeking benefit payments and partial incapacity benefits. Initially, the judge assigned to the claim denied the request for benefits. The worker appealed and underwent an independent medical examination. Eventually, the judge approved a lump sum settlement between the first insurer and the worker, stating that the case was settled and liability for the shoulder injury was accepted by the insurer.

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