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Massachusetts Appellate Court Reverses Finding that Injured Worker Was Not Entitled to Compensation for Continued Medical Treatment

One of the most challenging aspects of a workers’ compensation claim is determining when the injured worker requires continued medical treatment. If you are suffering from a painful and debilitating work-related condition, it is important that you receive the treatment and care that you deserve to make you as whole as possible. The dedicated team of Boston workers’ compensation lawyers at Pulgini & Norton are prepared to help you ensure that you receive the just outcome that you deserve.

In a recent claim, the worker suffered an injury to his left shoulder and a second work-related injury that affected his back. His employer’s insurer paid benefits until the date that he experienced the second injury when it paid him a new set of benefits. The insurer terminated the second set of benefits a few months later raising many issues, including pre-existing injury and lack of occupational cause.

The worker filed a claim for benefits for both injuries and the judge awarded benefits for the shoulder injury only. An independent medical examination was performed for the shoulder injury only, and a second independent medical examination was conducted for the back injury. The report for the back injury was later stricken, however, when it was discovered that the doctor had performed an examination of the employee in the past.

As part of his request for benefits and compensation, the employee sought reimbursement for the reasonable cost of shoulder surgery. During the hearing, however, the judge stated that the employee sought benefits only generally. He also adopted the impartial doctor’s conclusion that the employee was partially disabled due to the shoulder injury and that the employee had reached a medical end result pursuant to the doctor’s conclusions. The judge ultimately determined that there was no need for further medical treatment.

The worker appealed stating that it was an error to conclude that no further¬†medical treatment was necessary based on the doctor’s report. In the report, the doctor clearly stated that surgery to treat the shoulder “would be reasonable, necessary, and causally related” to the shoulder injury. The appellate court determined that the judge mistakenly equated a medical end result with a lack of need for further treatment. As a result, the appellate court recommitted the matter instructing the judge to reexamine the medical evidence and to make a new finding regarding the employee’s claim for medical expenses reimbursement.

The appellate court also reviewed the process that the judge used to determine the worker’s average weekly wage and concluded that the lower court may not have used a proper calculation. It therefore also instructed the lower court to set out the methodology used to determine the average weekly wage.

Work-related injuries can be debilitating, stressful, and potentially life-altering. At Pulgini & Norton, we serve Boston residents who were hurt on the job. We have handled a diverse range of injury types and have the experience it takes to navigate the complex Massachusetts workers’ compensation laws. We offer a free consultation so that you can learn more about our team and how we can assist you in seeking the outcome that you deserve. Call us now at 781-843-2200 or contact us online.

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