Massachusetts Injury Lawyers Blog

An appeal can leave a worker waiting for benefits even after an administrative ruling in the worker’s favor. Sometimes the next important development is the employer’s choice to stop contesting the claim. In a recent federal decision, the Benefits Review Board dismissed the employer’s appeal and returned the case for payment of benefits. The short order illustrates why the terms of a dismissal matter when determining what happens next. If an appeal or payment dispute affects your Massachusetts work injury claim, a Massachusetts workers’ compensation attorney can explain your case status and the steps needed to move it forward.

History of the Case

It is reported that the claimant’s federal black lung benefits case reached the Benefits Review Board after an administrative proceeding. The employer then filed a motion to withdraw its appeal and remand the case to the Office of Workers’ Compensation Programs for benefit payment.

Allegedly, the Board accepted the motion as a withdrawal of the employer’s opposition to all issues. It granted the request to dismiss the appeal under the applicable federal regulation and returned the case to the district director for the employer to pay the claimant’s benefits. Continue reading →

A breathing test cannot tell the whole story of whether someone can return to demanding physical work. The worker’s duties, medical limitations, and employment history may all affect entitlement to benefits. A recent decision upheld a black lung benefits award after examining both the miner’s years of qualifying employment and medical opinions about his ability to perform heavy labor. The ruling applies federal coal mine benefits rules, but it illustrates why a claim should connect medical evidence to actual job demands. If an occupational illness has affected your ability to work in Massachusetts, a Massachusetts workers’ compensation attorney can help evaluate the evidence relevant to your claim.

Facts of the Case

It is reported that the claimant filed a subsequent black lung claim in 2017 after three earlier claims had been denied. His most recent prior denial rested on the failure to establish total disability. The later claim went through additional administrative proceedings before an administrative law judge awarded benefits.

Allegedly, the employer challenged the award on several grounds. It disputed whether Blevins had enough qualifying coal mine employment to invoke the federal 15-year presumption, whether he had a totally disabling respiratory impairment, and whether the employer’s medical evidence defeated the presumption. Continue reading →

Winning benefits for an occupational illness may not end the fight over medical bills. An employer may still argue that treatment addressed a different condition, even when the worker’s lung disease has already been established. A recent Massachusetts decision explains why an employer could not defeat reimbursement by relying on medical opinions that conflicted with an earlier benefits award. Although the case involved federal black lung benefits, it highlights the importance of a clear medical record in disputes over work-related treatment. If you are facing a treatment dispute under Massachusetts law, a Massachusetts workers’ compensation attorney can review the denial and the evidence supporting your care.

Facts of the Case

It is alleged that the claimant filed a federal black lung benefits claim in 2012. After his death in 2016, a coadministrator of his estate continued the claim. An administrative law judge awarded benefits in 2019, finding that the employer had not rebutted the applicable presumption of entitlement. The employer did not appeal that award.

The Black Lung Disability Trust Fund had paid for pulmonary treatment between May 2013 and April 2016. The dispute that later reached the Benefits Review Board concerned the employer’s obligation to reimburse those expenses. After reviewing the charges, the government sought $90,386.50. The administrative law judge ordered reimbursement, and the employer appealed. Continue reading →

Being called an independent contractor can raise serious questions about a worker’s rights. When a public agency is involved, however, the dispute may turn on more than who controlled the work or signed the checks. A recent Massachusetts decision examined whether sovereign immunity barred claims for unpaid wages and alleged misclassification. The court affirmed judgment for the defendants without deciding that the contractor classification was correct. If your employment status has also become an issue after a workplace injury, a Massachusetts workers’ compensation attorney can help identify the rules that govern your benefits claim.

Case Setting

It is alleged that the plaintiff worked as a director, dispatcher, and driver for a transportation vendor that provided nonemergency medical transportation services for the regional transit authority. He alleged that he had been misclassified as an independent contractor and should have been treated as an employee of the authority. His claims sought relief for unpaid wages, minimum wage violations, and overtime.

It is reported that the claims against most of the individual defendants were resolved on summary judgment because the evidence did not establish the necessary managerial roles. The remaining defendants, the authority and one individual, obtained judgment on the pleadings based on sovereign immunity. The plaintiff appealed. Continue reading →

An injured worker may remain unable to work even after the statutory period for temporary total incapacity benefits ends. What happens next can have a major effect on the household budget. A recent Massachusetts Department of Industrial Accidents Reviewing Board decision explains why a judge cannot find that a worker has no capacity to earn wages and then calculate partial incapacity benefits as though that worker could earn a full-time wage. If your benefits are about to change, ask a Massachusetts workers’ compensation attorney to review both the medical findings and the proposed weekly rate.

Facts and Procedural History

Reportedly, an airline employee tripped over a golf bag at work, fell backward, and used her arm to keep her head from striking the ground. She later reported continuing neck and shoulder symptoms. The insurer paid temporary total incapacity benefits for a period, then stopped. The employee sought their resumption, and an administrative judge heard evidence about her medical condition and ability to work.

Allegedly, the judge credited the employee’s account of her limitations and adopted several medical opinions. The judge found that the work injury continued to cause her symptoms and that she remained totally incapacitated from gainful employment. The judge awarded temporary total benefits through the end of the available statutory period. For the period after that, however, the judge assigned her an earning capacity of $600 per week and awarded only $28.63 per week in partial incapacity benefits. Both sides appealed: the insurer disputed causation and total incapacity, while the employee challenged the assumed earning capacity.

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An injured worker may discover that the company paying their wages never purchased workers’ compensation insurance. That discovery can make a claim feel hopeless, especially when several businesses participated in the job. In certain circumstances, Massachusetts law can place responsibility on an insurer higher in the contracting chain. A recent Reviewing Board decision involving a truck driver shows how that protection can operate and why a separate injury settlement does not automatically erase a benefit award. If coverage is disputed after a workplace accident, have an experienced Massachusetts workers’ compensation attorney examine every business and insurer involved.

Case Setting

Reportedly, a driver working for an uninsured subcontractor lost control of a tractor-trailer after a collision on a Massachusetts highway. The truck rolled onto its side, and the driver injured his shoulder and hand. The subcontractor’s lack of coverage brought the insurer for another company in the contracting arrangement into the workers’ compensation case under section 18 of the Massachusetts statute. The Workers’ Compensation Trust Fund and that insurer disputed liability and benefits on several grounds.

Allegedly, an administrative judge ordered the higher-tier company’s insurer to pay a closed period of temporary total incapacity benefits, followed by partial incapacity benefits and medical expenses. The driver had also brought a civil claim against the other motorist involved in the crash. That claim settled before the workers’ compensation hearing. The hearing record disclosed the settlement amount, but it did not establish how the money was allocated among the driver’s claim, a family member’s claim, legal fees, and other components.

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Someone who cannot return to a physically demanding job may still answer calls, prepare estimates, or supervise a small business. Those activities raise two different questions in a Massachusetts workers’ compensation claim: how much the worker can earn, and whether all earnings were accurately reported. A recent Reviewing Board decision sent a case back for answers to both. If you receive weekly benefits while doing any paid work, including self-employment, seek legal guidance about reporting that work and how it may affect your benefits.

Factual History and Procedural Setting

Reportedly, a municipal employee hurt his back while lifting at work. He also operated a seasonal irrigation business and sometimes plowed snow. After the injury, he continued some lighter tasks for his company and hired others for physical installation work. Medical testing showed a disc problem, and he received treatment. He sought total benefits for one period, partial benefits thereafter, and payment of medical expenses.

Allegedly, the self-insurer presented bank and business records, an employee earnings report, and surveillance evidence. The worker acknowledged that he had received snowplowing income that he had not reported. An administrative judge found that he could perform some light work, assigned a $600 weekly earning capacity, awarded partial incapacity and medical benefits, and rejected the insurer’s fraud claim. The insurer appealed both the earning-capacity finding and the rejection of its allegation that the worker had failed to report income properly.

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Filing a workers’ compensation claim often begins with a short medical note, not a complete report. Massachusetts regulations set requirements for documents submitted with claims for weekly incapacity benefits, but a recent Reviewing Board decision shows why the timing of an objection matters. The ruling also illustrates the difference between the documents needed to start a claim and the evidence considered at a hearing. If an insurer challenges your claim over paperwork, speak with a Massachusetts workers’ compensation attorney before assuming the case is over.

Facts and Procedural History

Reportedly, a correction officer injured his right knee while restraining an inmate and underwent surgery. He later returned to full duty. About two years later, he felt a pop in the same knee while running to an emergency at a different facility. After another return to work, increasing pain made stairs and routine duties difficult. A treating physician eventually took him out of work, and another surgeon recommended a knee replacement.

Allegedly, the officer filed benefit claims involving both injury dates. He attached a one-page form signed by his treating physician, with a check mark next to the statement that he could not work at that time. The Department of Industrial Accidents accepted the claims for processing. Following a hearing, an administrative judge awarded temporary total incapacity and medical benefits based on the earlier injury. The self-insurer appealed, arguing that the form did not satisfy the filing regulation and that the entire claim should have been dismissed.

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Arriving early for work does not automatically place an employee outside Massachusetts workers’ compensation law, even when the employee chooses an unsafe entrance. A recent Reviewing Board decision examined whether a kitchen worker’s fall while climbing a locked fence arose out of employment and whether serious and willful misconduct could bar benefits. Fault generally does not control the threshold question of work connection. If an insurer claims that your injury happened outside the course of employment, consult a skilled Massachusetts workers’ compensation attorney promptly about your rights.

The Early Arrival, Serious Injury, and Denial of the Claim

Reportedly, the employer operated a brewery and beer hall with several entrances. The kitchen door generally opened at 8:00 a.m., while workers with key cards could enter earlier. The employee prepared food, cleaned, and accepted deliveries. Although his shift started at 9:00 a.m. and a supervisor had told him not to arrive early, he sometimes began near 8:00 a.m. by using an open beer-garden gate. The employer paid all time recorded after he clocked in.

It is alleged that the employee arrived before 7:00 a.m. on September 16, 2022, found the gate locked, and tried to climb the fence. He fell about eight feet and fractured his right hip. The employee claimed Section 34 temporary total incapacity benefits and Sections 13 and 30 medical benefits. An administrative judge denied the claim at conference, and the employee appealed to a de novo hearing. The judge again denied the claim, finding that the climb arose from the employee’s desire to clock in two hours early rather than from his employment. The judge consequently did not decide the insurer’s Section 27 serious and willful misconduct defense. The employee appealed. Continue reading →

A workers’ compensation award can depend as much on the issues the parties preserve as on the evidence they introduce. In a recent Massachusetts decision, an insurer challenged an employee’s average weekly wage after previously stipulating to that figure, while both sides agreed that the permanent total disability rate required a small mathematical correction. The ruling shows why stipulations, hearing memoranda, and timely objections matter throughout a benefits case. If a workplace injury has left you unable to earn your former wages, speak with a knowledgeable Massachusetts workers’ compensation attorney about protecting your claim and calculating the benefits available to you.

The Employee’s Injury and Claim for Benefits

Reportedly, the employee performed general construction work and supervisory duties for the employer. In January 2020, staging moved while the employee was nailing siding to a wall, causing him to fall about six feet onto concrete and a bush. He struck his head and suffered bleeding but continued working. Persistent pain later led him to a hospital, where he described landing on his right shoulder and hitting his head. The employee eventually sought workers’ compensation benefits arising from the accident.

It is alleged that an administrative judge issued a conference order awarding Section 34 temporary total incapacity benefits at $600 per week, based on a $1,000 average weekly wage, beginning June 24, 2021, together with medical benefits. The insurer appealed to a de novo hearing. The judge found a compensable injury, credited the employee’s continuing pain, and adopted medical opinions connecting the accident to head, neck, shoulder, and knee conditions. The judge found permanent and total incapacity, continued Section 34 benefits through June 20, 2024, and awarded Section 34A benefits at $666.70 per week thereafter. The insurer appealed to the Reviewing Board. Continue reading →