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Massachusetts Appellate Court Denies Insurer’s Request to Discontinue or Modify Award of Disability Benefits in Work-Related Car Accident Case

Once you receive an award of workers’ compensation benefits, the process is far from over. The insurer that is required to pay your benefits may seek a modification or discontinuation of your payments. These companies do not always have injured workers’ best interests in mind, and they sometimes resort to complicated tactics to have a claim denied. Our knowledgeable team of Boston workers’ compensation lawyers is prepared to help you protect your right to compensation.A recent claim discussed an insurer’s request to discontinue, modify, or recoup benefit payments to an injured worker. The woman suffered an injury to her neck during a motor vehicle accident that the insurer originally accepted. The employee sought reimbursement for proposed medical treatments, but the request was denied. The worker appealed, and the judge ultimately required the insurer to pay for the treatments as well as to continue paying disability benefits. The insurer appealed, and the reviewing judge allowed the submission of gap medical records to provide more context. At the conclusion of this hearing, the judge ordered the insurer to continue paying the same amount of benefits to the employee.

The insurer appealed again, raising four specific assignments of error. First, the insurer alleged that the judge misstated expert medical opinion testimony in reaching a decision and that the judge relied on his own opinion regarding the employee’s apparent uncomfortable demeanor during the hearing instead of the independent medical examination. The insurer also alleged that the judge wrongfully rejected independent medical examination information and failed to make adequate findings regarding the worker’s prior occupations.

In responding to these challenges, the appellate court concluded that the lower court made one harmless error that did not warrant overturning the decision to maintain the employee’s benefits. Specifically, the appellate court referred to the judge’s statement that the worker appeared physically uncomfortable during the hearing and shifted in her seat frequently. The insurer challenged this finding on the basis that the record lacked any evidence showing that the employee was uncomfortable or shifted in her seat.

The appellate court reviewed the trial transcript and confirmed that the record lacked evidence of this behavior. In response, the appellate court discussed the rules of evidence, which state that a judge can consider only the evidence that has been properly introduced. A judge must also make proper identifications of any evidence considered in the final decision, which allows the parties to challenge the evidence and to establish a complete record for appeal.

If you were injured in a job-related accident, our seasoned team of Boston workers’ compensation lawyers is ready to assist you with seeking the outcome that you deserve. Even if you are simply curious about your potential legal rights, we are happy to meet with you to help you learn about the workers’ compensation system and whether you may be entitled to benefits. We assist workers who have suffered a wide range of work-related injuries throughout Massachusetts and pride ourselves on providing the responsive and personalized legal counsel that you deserve during this difficult time. To schedule your free consultation, call us at 781-843-2200 or contact us online.

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