Industrial Review Board Finds Judge Mischaracterized Medical Evidence and Massachusetts Employee’s Claim for Benefits Must be Reassigned to New Judge

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.

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.

Here, the self-insurer argued that the employee alleged a purely mental or emotional injury.  The Board noted that there was a discussion off the record concerning the nature of the claim, but this deprives parties of a transcript of statements, which also makes it hard for the reviewing court to assess the decision.  In this case, the judge had not indicated whether the injured worker claimed a physical injury with a disabling psychiatric sequela, or a pure mental or emotional injury.

Stating the rule that only a pure emotional or mental stress injury carries a heightened “predominant contributing cause” standard, as set forth in § 1(7A), the Board made clear that there is a lower standard for employees who suffer a physical injury.   Since the self-insurer raised the defense of a higher standard, the Board stated that they must have anticipated the judge would assume the employee brought a claim for a physical injury, with a psychiatric sequelae.

Next, the Board turned to the judge’s treatment of the medical evidence. While the Board rejected the self-insurer’s argument regarding the judge’s adoption of a medical opinion stating that the employee’s physical injury led to a psychiatric injury, they agreed that the judge’s decision was inconsistent.  According to the Board, the judge mischaracterized certain medical evidence and adopted such evidence in support of his findings.   For example, the judge characterized one doctor’s causation opinion, which was that the employee suffered from post-traumatic stress disorder, as consistent with another opinion that was different and had held that the “incident” included the employee being struck and responding, as well as the response from the employer. The third medical opinion, according to the Board, did not conclude the employee had suffered from post-traumatic stress disorder.

The rule, stated by the Board, is that when a judge adopts parts of two expert medical opinions that cannot be reconciled, the decision is internally inconsistent and “arbitrary and capricious.” This therefore requires recommittal for further factual findings.

The Board referred the case for reassignment to a new judge for a hearing de novo.

After suffering work-related injuries, you may be entitled to benefits and compensation, according to Massachusetts law.  At Pulgini & Norton, our workers’ compensation attorneys represent employees in their claims for workers’ compensation benefits.  We provide a free consultation and can be reached by calling (781) 843-2200.

More Blog Posts:

Reviewing Board Finds Massachusetts Employee Entitled to Benefits for Physical and Psychiatric Disabilities, Massachusetts Workers’ Compensation Lawyer Blog, August 17, 2017

Reviewing Board Recommits Case After Massachusetts Judge Erred in Failing to Consider Injured Employee’s Properly Admitted Evidence and Set Forth Disability Findings Inconsistent with Dates  Massachusetts Workers’ Compensation Lawyer Blog, Massachusetts Workers’ Compensation Lawyer Blog, July 6, 2017

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