Massachusetts Reviewing Board Addresses Inconsistencies of Fact and Medical Opinion Regarding Injured Worker’s Psychiatric Condition

Recently, the Massachusetts Reviewing Board of Industrial Accidents analyzed the issue of adopting medical opinions consistent with facts regarding workers’ compensation benefits for an employee suffering from work-related injuries. Kujtime Uka, an employee of Westwood Lodge Hospital, appealed a decision denying her claim for benefits based on two work-related incidents.   In Uka v. Westwood Lodge Hosp., the Reviewing Board assessed the judge’s factual findings and held they were inconsistent with the medical opinions regarding the injured employee’s alleged psychiatric conditions.

Ms. Uka worked as a Mental Health Associate for the Hospital.  The judge found that Ms. Uka was assaulted by patients on October 20, 2006, and again at work on May 26, 2008.  After suffering physical injuries, Ms. Uka was incapacitated from work from July 1, 2010 to October 11, 2011.  The judge also determined that Ms. Uka’s treatment for headaches and physical injuries was reasonable and compensable.  After adopting portions of the medical opinions of a medical professional, Dr. Michael Rater, M.D., the judge held that the assaults suffered by Ms. Uka did not cause her post traumatic stress disorder (PTSD) or other psychiatric conditions.

On appeal, Ms. Uka challenged the conclusion that she did not suffer from PTSD, contending that Dr. Rater’s opinion on that subject varied. Massachusetts law requires that judges find facts and adopt medical opinions consistent with the facts.  In this case, the Board stated that some of the judge’s findings in fact adopted the medical testimony finding a causal relationship between the work injury and PTSD.

The Reviewing Board examined the transcripts of Dr. Prater’s testimony, finding that Dr. Rater’s opinion differed based on the hypothetical questions presented by the litigants.  In Dr. Rater’s report, he endorsed a causal relationship between PTSD and Ms. Uka’s assault.  At a later deposition, Dr. Rater recanted his opinion but later conceded that a causal relationship between the work assaults and PTSD would depend on the facts. The Board stated that these facts were insufficient to discern which opinion of Dr. Rater’s should control.

Additionally, the Reviewing Board held that the judge had improperly relied on testimony provided by a Hospital representative. That representative testified that Ms. Uka was paid following the October 2006 assault. While it was not clear whether Ms. Uka worked during this period, this testimony conflicted with Ms. Uka’s testimony that she missed work following the 2006 assault. Dr. Rater had opined that the employee had returned to work two days after the 2006 assault and therefore did not suffer from PTSD.

The Reviewing Board vacated the decision.  The case was remanded for further findings of fact.

If you or a loved one has been injured while working, you may be entitled to compensation for your medical expenses and lost earnings.  At the Massachusetts firm of Pulgini & Norton, our workers’ compensation attorneys provide aggressive, trusted legal representation to injured individuals seeking compensation for their work injuries.  To discuss your benefits claim with one of our skilled attorneys, contact our office at (781) 843-2200 or through our website.

More Blog Posts:

Reviewing Board Addresses Evidence of Pre-Existing Condition in Massachusetts Workers’ Compensation Appeal, Massachusetts Workers’ Compensation Lawyer Blog, January 27, 2016

Massachusetts Employee Has Standing to Bring Claim for Reimbursement of Benefits Paid by MassHealth and Medicare, Massachusetts Workers’ Compensation Lawyer Blog, December 10, 2015


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