Massachusetts Department of Industrial Accidents Affirms Denial of Benefits to Injured Worker Based on Pre-Existing Condition

As dedicated Boston workers’ compensation lawyers, we have seen a multitude of work injury cases and assisted many employees with seeking the benefits they deserve. The claims process can be complicated, especially if you have a complicated medical history. As a recent opinion from the Department of Industrial Accidents shows, pre-existing medical conditions are a key consideration when developing a strategy to maximize your recovery.

The injured worker was employed in a position that required him to perform administrative tasks as well as occasionally restraining minors. During a fight between two clients, the plaintiff injured his right shoulder and lower back when he attempted to stop the fight. The injury required an operation to repair the torn rotator cuff as well as an operation to address his lower back injury.

The employee filed a claim for workers’ compensation benefits and reimbursement of his medical expenses. The employee underwent a medical examination as a part of the claim, and the doctor issued a report regarding his findings. The doctor who performed the employee’s back surgery was deposed at a hearing, as well as the doctor who operated on the employee’s torn rotator cuff.

At the conclusion of the hearing, the presiding judge adopted the opinion of the doctor who examined the employee, finding that the right shoulder injury was the direct and major cause of the injuries that the employee sustained and his need for surgery. The judge also concluded that the shoulder injury was resolved and no longer constituted a disability.

Turning to his lower back injury, the doctor concluded that the employee had pre-existing conditions that affected his back and that were aggravated at the time of the injury. The judge also adopted a finding that the injury was not a major cause of the employee’s back injury and need for treatment. The judge noted the employee’s two-year history of back problems and treatment in support of her finding. Ultimately, the judge denied the man’s request for benefits and medical treatment reimbursement related to his back injury.

The employee appealed this finding, arguing that the judge made a mistake by relying on one of the testifying doctor’s opinions, which the employee described as speculative in nature. The employee argued that the doctor’s finding that the back injury should have resolved by two months after the incident was not a sufficient basis for a finding that the injury was not a result of his work-related duties. The appellate court rejected this argument, finding that the doctor performed a proper examination and concluded that there was no causal relationship between the work incident and the employee’s back injury. Instead, the doctor testified that the lower back condition stemmed from the employee’s degenerative lumbar disorder and general poor fitness. As a result, the appellate court affirmed the lower court’s ruling.

If you were hurt at work, you deserve seasoned and attentive legal counsel to help you ensure that you are treated fairly. At Pulgini & Norton, we make sure every client is treated with the respect that they deserve. Your case won’t be treated like just another file on the shelf. To set up your free consultation, call us at 781-843-2200 or contact us online.

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