Massachusetts Reviewing Board Holds that Employee Failed to Meet Burden in Complex Psychological Case When Impartial Report Did Not Support Finding that Workload Resulted in Disability

The Massachusetts Reviewing Board of Industrial Accidents recently reviewed an administrative judge’s decision regarding § 34 and § 35 benefits, as well as § 13 and § 30 benefits, in a workers’ compensation appeal regarding an employee’s psychological harm. The Board reviewed whether the impartial examiner set forth an opinion that the predominant cause of the employee’s disability had been caused by workload issues.

The employee, 44 years old at the time of the hearing, worked as a corrections officer from February 2010 to March 20, 2012, and he alleged he suffered a psychiatric disability due to both his heavy workload and an inmate’s threat of harm.  The judge had found that the employee’s workload was the predominant cause of his disability. He also found that the employer’s actions were not “a personnel action,” so they did not immunize the employer from liability.  The self-insurer argued that the judge erred when he relied on the impartial examiner’s report after rejecting some of the history on which the report was based.

The employee in this case worked at MCI Concord as a corrections officer. He tested inmates for drugs and was assigned other duties as well. The employee testified to his heavy workload and the resulting stress caused by working overtime.  He also explained that an inmate threatened to harm him if he went back on an agreement not to raid his cell.

The employee’s supervisor testified on behalf of the self-insurer.  He denied that the employee stated he had been overwhelmed with work, and he also claimed that the employee did not report that an inmate had threatened him.

The judge credited the supervisor’s testimony. He noted inconsistencies in the employee’s affidavit and his testimony. He also found that the employee had not proven an inmate threatened him.

Under § 11A, a board-certified psychiatrist examined the employee.  The judge noted that the doctor’s report was adequate. The employee did not conduct a deposition or submit motions alleging that the medical opinion was inadequate.

Then, the judge adopted the psychiatrist’s opinion that the employee’s job and a “series of incidents” caused his depressive disorder and resulting disability.  The report stated that the employee suffered post traumatic stress disorder from extensive inmate threats to his life and to his children.

The judge stated that the conclusions set forth by the psychiatrist were beyond anything in the statements of his hearing testimony or affidavit and were therefore untrue.  The judge rejected the medical opinion to the extent it was based on “facts.” In sum, the judge stated that the unproven facts included the employee’s failure to prove that a threat had been made.

The judge did find that the overall workload served as the predominant contributing cause of the employee’s stress. Therefore, it constituted a “personal injury” under Massachusetts law.  Since the judge found the employee psychologically disabled by workplace stress caused by his “overall workload,” he ordered the self-insurer to pay § 34 benefits from March 21, 2012 until August 15, 2013, and then § 35 benefits.

The Board stated that the judge erred by relying on the psychiatrist’s impartial report, even though significant aspects of the factual basis of the report had been rejected. The rule is that an impartial examiner’s report does not hold weight if the fact finder does not believe the facts on which it is based.  Here, the judge relied on the psychiatrist’s opinion that the main cause of the employee’s disability was a series of incidents at work. The predominant cause of the employee’s depression and subsequent disability was his overall workload. But the psychiatrist’s opinion was based on the rejected notion that the employee received threats from inmates.  The workload issues had not been the focus of the report.

The Board further held that the psychiatrist’s opinion linked the diagnosis of PTSD to the inmate threats. But he did not link the depression diagnosis, which had been the condition for which the judge prescribed treatment, to the employee’s heavy workload and resulting stress. The depression diagnosis was related to the alleged threats and the employee’s reaction to threats.

The Board stated that the psychiatrist’s impartial report did not support the judge’s finding that it was the employee’s overall workload rather than the inmate threats that predominantly caused the employee’s psychological disability. The Board found that it had been an error for the judge to construe the impartial report in that manner.

The Board stated that the employee failed to meet his burden of proof.  They concluded that the employee did not depose the impartial physician, nor did he move to admit additional medical evidence.  The judge could not rely on other medical evidence, and the Board made clear that in a complex psychological case, such as the one at hand, the judge was not competent to determine causation in the absence of a medical opinion.

The Board reversed the decision awarding the employee benefits.

If you have suffered a work-related injury, you may be entitled to coverage for your medical treatment and expenses and lost wages under the Massachusetts Workers’ Compensation Act. At Pulgini & Norton, our experienced attorneys provide aggressive and thorough legal representation to clients seeking workers’ compensation benefits in Massachusetts. To discuss your benefits claim with one of our lawyers, contact our office at (781) 843-2200 or online and schedule a free consultation.

More Blog Posts:

Massachusetts Reviewing Board Addresses Inconsistencies of Fact and Medical Opinion Regarding Injured Worker’s Psychiatric Condition, Massachusetts Workers’ Compensation Lawyer Blog, June 9, 2016

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

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