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People are often asked to sign waivers before engaging in activities that may be perceived as dangerous. Under Massachusetts personal injury law, signing such a waiver generally precludes the person who signed the waiver from pursuing a negligence claim against the released party. In Cahalane v. Skydive Cape Cod, however, the Appeals Court of the Commonwealth of Massachusetts held that it would not prevent the injured party from recovering for any gross negligence in contravention of the terms of the agreement.

In Cahalane, Plaintiff engaged Defendant’s services to go on a tandem skydive jump. Prior to embarking on her jump, Plaintiff signed a waiver in which she released any claims against Defendant for negligence or gross negligence. Plaintiff was permitted to purchase a release from the waiver, but chose not to do so. During the jump, Plaintiff was attached to an instructor. As they approached the ground the instructor performed a hook turn. Hook turns are disapproved of in skydiving safety bulletins, as they are a leading cause of death and injury in skydiving. Due to the manner in which the pair landed, both of Plaintiff’s femurs were fractured on impact. Plaintiff sued Defendant, alleging negligence and gross negligence. Defendant filed a Motion for Summary Judgment, arguing that the waiver barred Plaintiff’s claims. The trial court granted Defendant’s Motion and Plaintiff appealed, arguing the waiver was induced by fraud and was unenforceable. On appeal, the court held that the waiver was enforceable and precluded Plaintiff’s negligence claim but ruled that it did not bar Plaintiff’s gross negligence claim.

The court noted that Plaintiff was given ample opportunity to review the waiver and did not produce evidence that anyone made any false representations to her regarding the waiver. As such, the court held it was enforceable. The court noted, however, that while Massachusetts law favors the enforcement of releases for liability for negligent acts, a party cannot immunize itself from liability for grossly negligent or reckless acts. The court explained that gross negligence is more than a failure to exercise ordinary care and was better explained as great negligence, or conduct without any diligence or care. The court noted each case must be analyzed on its facts to determine if the defendant’s actions were grossly negligent, but additionally noted that a moment of inattentiveness in a dangerous situation could constitute gross negligence. As such, the court held that the question of whether Defendant was grossly negligent and therefore liable to Plaintiff could not be decided via summary judgment but must be submitted to a jury.

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Collateral estoppel is a long-standing rule of law that people can only get “one bite of the apple.” In other words, people are not entitled to re-litigate the same facts or claims until they reach a verdict of their liking. There are certain requirements that must be met to preclude litigation due to collateral estoppel, however, and simply because facts were previously decided in another forum does not automatically prevent a court from allowing the same facts to be litigated. In workers’ compensation cases it is important to know whether you or your employer’s insurer are held to facts determined in a prior proceeding. In Yahoub’s case, the Appeals Court of the Commonwealth of Massachusetts held that an employer was not barred from litigating facts in a Massachusetts workers’ compensation claim that were previously found by the Department of Industrial Accidents.

In Yahoub, claimant was working as a custodian for the town of Milton when he sustained injuries in an altercation with his supervisor. After an investigation, claimant was determined to be the aggressor of the incident and was terminated. He then filed a claim for unemployment benefits with the Division of Unemployment Assistance who awarded him benefits after finding the town had not proven claimant engaged in deliberate misconduct that constituted a willful disregard of the town’s interest. The town appealed to the District Court, but the District Court affirmed the decision of the Division of Unemployment Assistance.

Claimant then filed a claim with the Department of Industrial Accidents seeking workers’ compensation benefits for severe emotional distress, which he alleged was caused by the altercation. A hearing was conducted in which testimony was presented from claimant, his supervisor, and a witness. During the hearing, the town’s workers’ compensation insurer argued claimant was not entitled to recover benefits due to the fact that his actions amounted to willful and serious misconduct and his termination was a bona fide personnel action.  Following the first day of the hearing, claimant moved to prohibit the insurer from re-litigating the facts found by the Division of Unemployment Assistance, under a theory of collateral estoppel. The administrative judge denied claimant’s motion due to lack of privity between the parties in each proceeding. At the conclusion of the hearing, the administrative judge agreed with the insurer and found claimant had initiated the altercation, and denied claimant’s claim. Claimant subsequently appealed to the reviewing board. The reviewing board affirmed the administrative judge’s ruling. Claimant subsequently filed an appeal with the Appeals Court of the Commonwealth of Massachusetts.

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If you are injured while performing the duties of your job, you are most likely entitled to workers’ compensation benefits. Under Massachusetts workers’ compensation law, you are only entitled to benefits that are reasonable and related to your injury. There are guidelines set forth as to what treatment is considered reasonable, and any deviation from the guidelines is presumed to be both unreasonable and inappropriate. In Thibeault’s Case, however, the Court of Appeals of Massachusetts held the presumption of unreasonableness can be overcome if the facts of the case indicate other treatment is acceptable.In Thibeault, the employee was a heavy equipment operator, who injured his lower back moving a steel plate while working for his employer. He was diagnosed with discogenic back pain and a tear and disc bulge in the lumbar region. The employee underwent treatment for his back injury but declined to undergo surgery. He filed a workers’ compensation claim and received a lump sum settlement. The employee continued to get treatment from his primary care physician for his back injuries after he received the settlement. Part of the employee’s treatment included prescriptions for narcotic pain medication.

Subsequently, eight years after the employee received his lump sum settlement, he filed a post lump sum claim for medical benefits, which was denied. He then underwent an independent medical examination, after which the examining doctor issued a report and was deposed. The doctor stated, in part, that the employee suffered from chronic low back pain, which the employee was treating with medication. The doctor further stated that, although there did not seem to be any steps taken to reduce the dosage or wean the employee off the medication, continuing to treat with medication was reasonable, and the treatment was causally related to the employee’s workplace injury.

A hearing was held on the employee’s claim for post lump sum benefits, after which the administrative judge ruled in favor of the employee. The judge noted that while treating with medication was not the preferred protocol under the treatment guidelines, the doctor who performed the employee’s medical exam found the treatment to be reasonable and related to the original injury. The insurer appealed to the Department of Industrial Accidents reviewing board, which affirmed the administrative judge’s ruling. The insurer then appealed to the Appeals Court of Massachusetts.

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People routinely entrust their health to medical providers with the expectation they will be provided with appropriate care. Unfortunately, at times, the medical treatment provided falls short of what is expected and actually results in harm to the patient. If treating providers fail to adhere to the standard of care imposed on them, they should be liable for any damages caused. The attorneys who defend doctors and hospitals in medical malpractice cases are often aggressive and will engage in several tactics to try to diminish any damages caused by their clients. The Massachusetts Court of Appeals recently held in Larkin v. Dedham Medical Associates, Inc., however, that a plaintiff’s future medical damages in a medical malpractice case are not entirely reliant on their past medical expenses. If you are pursuing a medical malpractice case in Massachusetts, it is important to have an aggressive Massachusetts medical malpractice attorney advocating on your behalf to enable you to recover the maximum damages possible.In Larkin, the plaintiff-wife was diagnosed by her primary care physician with a venous varix on the left side of her brain and an aneurysm on the right side of her brain. She underwent initial diagnostic testing at the direction of her physician, but he failed to order any follow-up testing. Additionally, when she became pregnant, he failed to report her brain abnormalities to her obstetrician. Due to the physical stress of giving birth to her child, the plaintiff-wife’s venous varix experienced an increase in intracranial pressure, and a clot formed. The plaintiff-wife subsequently suffered a stroke, which required extensive surgery and resulted in the permanent loss of her ability to walk or care for herself. She requires constant care, day and night, for the rest of her life.

The plaintiff-wife, along with her husband and child, sued her primary care physician and his practice group, seeking damages for pain and suffering, lost wages, past medical expenses, and future medical expenses. The plaintiff-husband also sought damages for loss of consortium. Following a jury trial, the plaintiffs were awarded $35.4 million, which included an award of $11 million for future medical expenses. The defendants filed multiple post-trial motions, arguing, among other things, that the plaintiffs’ counsel misrepresented the cost of the plaintiff-wife’s past medical bills, resulting in inflated future medical damages. The court denied the majority of the post-trial motions, and the defendants appealed. On appeal, the Massachusetts Court of Appeals affirmed.

Regarding the plaintiff-wife’s medical expenses, it was undisputed that the plaintiffs’ attorney misrepresented the plaintiff-wife’s past medical expenses as $4 million, when they were in fact $1,272,013.70. Following the trial, the judge rectified this error by reducing the verdict award for past medical expenses to reflect the actual amount. The defendants argued, however, that since the plaintiffs introduced limited evidence regarding future medical costs, the jury relied on the inflated amount of past medical expenses in awarding damages for the cost of future care, leading to an improper amount. The court disagreed with the defendants and sustained the future damages award. First, the court noted that an expert opinion is not required to prove future medical damages. The court also found the jury could have reasonably awarded $11 million in damages for future medical costs without relying on the misrepresentation, and it found that the trial court did not err in reducing the award only for past medical bills.

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Many people avoid thinking about what will happen to their property and assets after their death, and ultimately die without a will to determine how their estate will be disbursed. Family members of an individual who dies intestate may not see the necessity in determining how the estate should be divided and may delay in taking any action to raise an estate and appoint a personal representative. The failure to take prompt action when a person passes away can have a damaging effect on your ability to control the estate’s assets, however. A recent Massachusetts estate planning decision held that you waive certain rights if you do not act in a timely manner.

In Bennett v. R.J. Reynolds Tobacco Company, the Superior Court of Massachusetts defined what rights a limited personal representative has with regards to a decedent’s estate.  Specifically, the court addressed whether a personal representative who is granted limited authority under the Uniform Probate Code (UPC) has standing to pursue tort actions that are an asset of the decedent’s estate. In Bennet, the Plaintiff’s father died on March 7, 2014. Section 3-108 of the UPC provides that no testacy or appointment proceeding may take place more than three years after a decedent’s death. If no personal representative has been appointed within three years of a decedent’s death, section 3-108(4) of the UPC allows for a personal representative to be named, but only for the limited purpose of determining successors to the estate. Section 3-108(4) specifically states, however, the representative does not have the right to possess any estate assets. Plaintiff was appointed the limited representative of the estate, pursuant to section 3-108(4), on July 26, 2017.

Plaintiff subsequently brought claims of wrongful death and civil conspiracy against the Defendant, as the limited personal representative of the estate of her deceased father.  The Defendant filed a motion to dismiss the Complaint, arguing the Plaintiff’s appointment as a personal representative of the estate under section 3-108(4) of the UPC did not grant her the authority to pursue a wrongful death claim or any tort claim that belonged to the decedent and became a part of the decedent’s estate upon his death.

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Bullying is a persistent and ever growing problem throughout the schools in our nation, including schools in Massachusetts. While generally bullying is thought of as causing emotional harm, it often results in physical harm as well. Parents may be unsure who should be held accountable when their child suffers a personal injury due to bullying. Recently, the Massachusetts Supreme Judicial Court held that public defendants in Massachusetts personal injury cases are protected from liability for negligently failing to prevent the bullying and physical assault of a child.

In Cormier v. City of Lynn, a classmate pushed the child victim down a flight of stairs. The fall caused a spinal injury that ultimately resulted in the victim’s permanent paralysis. The victim’s parents brought a lawsuit against several defendants, including the City of Lynn, the school district and their public employees. The victim’s parents alleged that the victim had been subjected to constant bullying over the school year, and that his mother had reported harassing acts to the school officials on several occasions. The victim had reported acts of bullying and harassment to his teachers and school administrators as well. The victim’s parents alleged the school negligently failed to enforce its own anti-bullying policies and procedures.

The City of Lynn, school district and public employees filed a motion to dismiss arguing the claims against them were barred by the Massachusetts Torts Claim Act. The motion to dismiss was granted and affirmed on appeal. The Massachusetts Supreme Judicial Court granted the victim’s parents’ motion for further review on whether the Massachusetts Torts Claims Act barred them from bringing claims against the public defendants for negligently failing to prevent the victim from being bullied.

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Under the Massachusetts Workers’ Compensation Act (the Act) an individual who suffers a workplace injury is entitled to benefits. While obtaining benefits due to a covered injury is generally a relatively straightforward process, it can become complicated if your employer is unable to provide benefits. Generally, employers maintain insurance policies that provide coverage for workers’ compensation claims, but if your employer is self-insured and becomes insolvent it may not initially be clear who is responsible for your benefits. Recently, the Appeals Court of Massachusetts addressed the issue of who bears the responsibility of paying benefits when an employer becomes insolvent, and ultimately held that under Massachusetts Workers Compensation law a reinsurer is required to pay workers’ compensation benefits if a self-insured employer’s surety bond is exhausted.

In Janocha, the facts were undisputed. The employee suffered a workplace injury, which resulted in a permanent and total incapacitation for work. At the time of the employee’s injury the employer was self-insured, and held both a surety bond with a bond holder and a reinsurance policy with a reinsurer, pursuant to the terms of the Act. The reinsurance policy contained a retention provision, which stated the reinsurer would provide indemnification for covered losses once the benefits paid for a covered loss reached $400,000. The employer paid the employee’s benefits directly from the time of the employee’s injury until the employer’s bankruptcy in 2007, after which the bond holder issued payments directly to the employee. In 2012, the bond was exhausted and no further payments were made to the employee; however, the $400,000 retention limit had not been reached.

The employee filed a claim against the reinsurer, seeking reinstatement of his benefits. Following a hearing, an administrative judge held that once the employer’s bond was exhausted the employer was uninsured under the terms of the act and, therefore, the workers’ compensation trust fund was responsible for providing the employee’s workers’ compensation benefits until the payments reached $400,000. The trust fund appealed. On appea,l the workers’ compensation board reversed the administrative judge’s ruling, finding that the provisions of the Act stated the trust would only be the responsible party when the employer was uninsured on the date of the injury. As such, the board found the reinsurer to be responsible for paying benefits directly to the employee. The board further ruled that the reinsurer must act as a guarantee of a self-insured employer’s ability to pay benefits, and found the retention limit was void, as it conflicted with the reinsurer’s statutory obligation to provide benefits to the employee. The reinsurer appealed to the Appeals Court of Massachusetts.

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Generally speaking, a property owner does not have a duty to prevent dangerous or harmful acts of third parties. Under Massachusetts personal injury law there is an exception to the general rule, in that a property owner can be held liable for ignoring criminal activity it knew or should have known was occurring on the premises. In Charles Northrup v. National Amusements, the Appeals Court of the Commonwealth of Massachusetts recently clarified that a property owner will only be liable for a criminal act occurring on its property if it had knowledge of prior similar acts.

In Northrup, the Plaintiff was sitting in his vehicle in the parking lot of the Defendant’s movie theater, when he was stabbed by an individual suffering from schizophrenia and other mental illnesses. Plaintiff subsequently sued the Defendant for negligence, alleging the Defendant’s failure to provide police protection on the premises caused his injuries. The Defendant filed a Motion for Summary Judgment, arguing the stabbing was not foreseeable. The trial court granted Defendant’s Motion and Plaintiff appealed. On appeal, the Appeals Court of the Commonwealth of Massachusetts affirmed.

The court noted that while police reports indicated there were thirty incidents at the movie theater in the three years prior to the incident, only three of the incidents resulted in an arrest, and only one incident involved a violent act. The remainder of the incidents involved theft and other property crimes. Additionally, the internal incident reports written by the Defendant indicated there were seventy-one incidents in the three-year period prior to the stabbing. While most of the incident reports did not indicate any criminal activity, four of the reports indicated violent acts, including one report of an incident in which rocks were thrown at children when they were leaving the theater.

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Insurers can raise an “affirmative defense” during the proceedings related to a claim for Massachusetts workers’ compensation benefits.  One such defense is allowed by the Worker’s Compensation Act, which prevents someone from receiving benefits when they’ve rejected treatment that can lessen her or his suffering through reasonable remedies and operations available through the medical profession.  The injured needn’t try every possible medical procedure, just those where it appears there is substantial gain to be had, which do not subject the injured to unusual risk or danger. 

Recently, the Massachusetts Reviewing Board looked at whether an affirmative defense was appropriately raised and considered.  The employee claiming § 34 temporary total incapacity benefits in this action was a vending machine route delivery driver.  He worked for over twenty years in this position as part of his forty-year work history.  His job involved repetitive motions carrying heavy boxes of coins weighing up to 100 pounds.  In 2015, he injured various locations on his right arm after falling down steps at work.  The deliveryman’s employer began the payment of § 34 temporary total incapacity benefits, and the employee has not worked since. 

After ten months, the insurer filed to modify or stop the § 34 benefits after a medical report from the insurer’s examining physician.  This report relayed that the employee was able to return to light work with limited lifting.  The employee filed for permanent and total incapacity benefits.  The claims moved onto a §10A conference where the judge granted the motion for permanent benefits and ended the insurer’s motion to discontinue.

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The Commonwealth’s Supreme Court reviewed a new issue recently in a Massachusetts wrongful death law suit.  The legal question was whether a pharmacy was required by law to notify the prescribing physician after the patient’s health insurer advises the pharmacy that it needs a “prior authorization form” filled out by the physician.  The decedent was prescribed Topamax to treat her epilepsy.  The medication controlled her life-threatening seizures.  Her insurer paid for this prescription twice in the months before her nineteenth birthday, but refused to do so afterward because it did not have a prior authorization form for an insured who is older than eighteen.  The woman’s family made multiple attempts to obtain the medication, but the pharmacy refused to fill it.  The family could not afford the medication without insurance and the woman died from a fatal seizure that year.

The woman’s mother and executor brought an action for wrongful death and punitive damages against the pharmacy, her daughter’s neurologist, and the neurological practice.  The mother testified at trial that the pharmacy repeatedly told her daughter and other family members the pharmacy would notify her doctor about the need for prior authorization, but the physician and his practice denied receiving notice.  The trial court granted the pharmacy’s motion for the summary judgment on the legal basis that the pharmacy had no legal duty to the decedent to notify her doctor and the practice about the need for prior authorization.

Prior authorization was required by MassHealth to establish the medical effectiveness and necessity of the medicine.  This was to ensure there were no other cost-effective options to use, or generic drugs.  The form was two pages long and took less than ten minutes to complete. It provided information about the diagnosis, the prescribed medication, basic patient  information ,the doctor’s information, and the prescriber’s signature.  The form was accepted only by the prescribing physician.  Pharmacies and patients were not allowed to complete the form.  The insurer only told the pharmacy because it was the pharmacy that submitted the claim for coverage. 

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