Massachusetts Appellate Court Remands Award of Total Incapacity Benefits Based on Lack of Evidence

A complicated aspect of any Massachusetts workers’ compensation claim is determining the nature and extent of the injury, especially when the claimant has prior injuries or health conditions. At Pulgini & Norton, we have counseled numerous Massachusetts residents regarding their rights following a work-related injury. As a recent appellate opinion indicates, if your employer’s insurance carrier decides to appeal any decision awarding you benefits, having a seasoned attorney on your side can make all of the difference.

The background of the case is as follows. The claimant was a plumber who suffered injuries to his neck during sleep. As a result of these injuries, the plumber underwent a procedure on his neck in 2004 and eventually returned to work. About four years later, the plumber, who had been self-employed, took a job working for a plumbing company. In 2013, the employee reported pain and stiffness in his neck after he operated a hammer drill for approximately one hour. The plaintiff sought medical treatment from a neurosurgeon.

The employer, which was self-insured, paid the employee benefit payments for a period of time. Then, the employee filed a claim seeking incapacity benefits on a continuing basis. The judge reviewing the application ordered the employer to pay the employee benefits for the time period from when he was injured and continuing. After the award, the employee underwent an impartial medical examination. The doctor determined that the neurosurgeon who originally treated the employee did not give enough weight to his preexisting neck injury and cervical spinal procedure. The employer moved to admit the additional medical testimony, which the judge allowed.

Reviewing this medical evidence, the judge concluded that the preexisting condition was not the major cause of the employee’s disability and ordered the employer to continue paying incapacity benefits. The employer appealed, first challenging the judge’s decision that the employee’s work-related injury was the major cause of his disability. The appellate court first stated the governing rule that a judge has the power to credit the medical opinion of one expert above another. Without a finding that the judge acted in an arbitrary and capricious manner, the appellate court upheld this determination.

Next, the employer challenged the judge’s award of total disability benefits. The lower court judge cited testimony from the treating physician indicating that the employee would likely return to his occupation as a plumber in the future. The appellate court agreed with this evidentiary conclusion but noted that the court had failed to make the appropriate findings of fact regarding whether the employee was entitled to total incapacity benefits. As a result, the appellate court remanded the case for further proceedings on the issue of whether or not the employee was entitled to total incapacity benefits.

If you have been injured on the job, you may be entitled to workers’ compensation benefits. At Pulgini & Norton, our Massachusetts work injury lawyers have the experience and tenacity it takes to ensure that your rights are protected and that you receive the compensation that you deserve in a timely fashion. We provide a free consultation so that you can learn more about whether you are entitled to benefits and how we can assist you. To set up your free consultation, call us now at 781-843-2200 or contact us online.

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