It is well-established under Massachusetts law that employees hurt while working can recover workers’ compensation benefits from their employers. In practice, the employer’s workers’ compensation insurer will typically provide such benefits. As such, when more than one insurer covers an employer, it may be unclear which one is responsible for paying claims, as illustrated in a recent Massachusetts case. If you were hurt at work, it is wise to talk to a Massachusetts Workers’ Compensation attorney about your rights.
Factual and Procedural History
It is alleged that the employee, a Massachusetts resident, was hired by the employer in Massachusetts to work as a camp counselor and unit leader at a camp in New Hampshire during the summer of 1994. She sustained an injury in July while working at the camp, received treatment at a New Hampshire hospital, and was released the same day. The employer had two workers’ compensation insurance policies at the time: one covering New Hampshire claims, excluding Massachusetts claims, and one covering only Massachusetts claims. The New Hampshire insurer paid some medical bills under its New Hampshire policy but denied weekly benefits due to insufficient medical evidence of disability.
It is reported that after returning to Massachusetts, the employee filed a claim with the Commonwealth’s Department of Industrial Accidents (DIA) against the New Hampshire insurer, which was denied on the basis that the New Hampshire insurer’s policy did not cover Massachusetts law. Subsequently, the employee filed a claim against the Massachusetts insurer. An administrative judge ordered the New Hampshire insurer to pay the benefits, which the New Hampshire insurer contested, asserting it was not liable under Massachusetts law.
Allegedly, the Massachusetts insurer accepted an amended order to pay benefits while appealing the decision. After an evidentiary hearing, the administrative judge found the New Hampshire insurer to be an insurer under Massachusetts law, waived the New Hampshire insurer’s defense due to its failure to assert it initially, and ordered various payments and penalties against the New Hampshire insurer. The New Hampshire insurer appealed to the reviewing board, which reversed the administrative judge’s orders, directing the Massachusetts insurer to pay the employee’s benefits and legal fees. The New Hampshire insurer sought clarification on reimbursement, which the reviewing board denied, stating the decision sufficiently outlined the parties’ rights and obligations. The New Hampshire insurer appealed.
Determining What State’s Law Applies in Workers’ Compensation Cases
The court evaluated the case by assessing whether Massachusetts law applied to the employee’s claim, concluding that it did because the employment contract was entered into in Massachusetts. The court scrutinized the definition of an insurer under Massachusetts law, finding that the New Hampshire insurer’s policy explicitly excluded coverage under Massachusetts law while the Massachusetts insurer’s policy was limited to Massachusetts coverage.
The court agreed with the reviewing board’s decision that the New Hampshire insurer was not an insurer under Massachusetts law, noting that the policy terms were clear and should be enforced as written. The court agreed with the reviewing board that the Massachusetts insurer was responsible for the workers’ compensation payments despite the New Hampshire insurer’s premiums reflecting the employee’s wages.
The reviewing board’s reversal of penalties against the New Hampshire insurer was also upheld, as the New Hampshire insurer was never subject to liability under Massachusetts law and thus could not be penalized for non-compliance. Regarding recoupment, the court acknowledged the statutory and case law support for recovering payments made under workers’ compensation but emphasized that such matters involved discretion and fact-finding, tasks beyond the purview of the court or reviewing board.
Consequently, the court affirmed the reviewing board’s decision and left the parties to pursue any further administrative remedies.
Consult with a Competent Massachusetts Workers’ Compensation Attorney
Employees who sustain injuries at work are entitled to pursue workers’ compensation benefits, but employers frequently challenge the work-related cause of an injury to avoid covering claims. If you were hurt while working, it is advisable to consult with an attorney about your options. Attorney James K. Meehan is a competent Massachusetts workers’ compensation lawyer who can explain your rights and assist you in seeking the most favorable legal outcome for your case. You can contact Attorney Meehan at 508-822-6600 or use our easy online contact form to schedule a private consultation.