Massachusetts Appellate Court Upholds Award of Benefits for Injured Nurse but Denies Payment of Benefits for Existing Injury Based on Employee’s Failure to Timely Raise the Issue

If 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.

The employee appealed on three grounds. First, she claimed that the judge erred in adopting medical restrictions that were inconsistent with the employer’s vocational expert’s testimony. Second, she alleged that the court erroneously used income information from the wrong year. Finally, she alleged that the judge used the wrong legal standard when addressing the causal relationship between the injury and her left knee.

Taking each assignment of error in turn, the appellate court first upheld the judge’s medical restrictions assessment and adoption of the vocational expert’s testimony that sedentary employment positions involved some walking and standing. Next, the court concluded that the judge made an error when calculating the employee’s earning capacity, relying on reports from the incorrect year. Finally, the appellate court rejected the employee’s argument that the judge improperly assessed the causal link between the injury and her left knee, noting that the employee failed to raise any objection to the use of the analysis earlier in the proceedings. Evidence in the record showed that the judge properly analyzed the implications of the accident on the left knee, which both parties acknowledged as a pre-existing condition that was not related to her job duties.

Ultimately, the appellate court affirmed the decision requiring the insurer to pay benefits but modified the employee’s earning capacity according to the appropriate records.

If you were hurt on the job, it is critical that you seek medical and legal advice as soon as possible. There are many different steps that an injured worker must take to preserve his or her right to workers’ compensation benefits and the process can be incredibly overwhelming amidst the stress and inconvenience of your injury. Our dedicated team will assist you through each phase of the process while ensuring that you are treated fairly. Call us now at 781-843-2200 or contact us online to set up a free consultation.

Related Posts

Massachusetts Appellate Court Considers Workers’ Compensation Claim Involving Multiple Insurers and Dispute Regarding Coverage for Nursing Fall Injury

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

Massachusetts Appellate Court Upholds Denial of Benefits in Claimed Psychiatric Injury Case Based on Lack of Medical Evidence

 

Contact Information