Articles Posted in Workers’ Compensation

The Massachusetts Workers’ Compensation Act (the Act) affords workers the right to recover benefits for work-related injuries or illnesses. However, this right comes with a trade-off. Specifically, in exchange for these benefits, workers are generally precluded from suing their employers in tort for damages. This legal framework is designed to provide a streamlined and efficient process for compensating injured workers. Yet, complications can arise, particularly in cases where the identity of the employer is not immediately clear, as illustrated in a recent Massachusetts case in which the court ultimately dismissed the plaintiff’s claims in tort. If you were hurt while working, it is advisable to speak to a Massachusetts workers’ compensation attorney about what benefits you may be able to recover.

History of the Case

Allegedly, the plaintiff filed personal injury claims against the defendant. The defendant moved for summary judgment, arguing that the plaintiff’s claims were barred by the exclusivity provision of the Act. The plaintiff opposed the motion and argued that an entity distinct from the defendant was his employer at the time of the accident, thus challenging the defendant’s entitlement to immunity.

It is reported that the records indicated that the defendant retained and paid the entity for non-production payroll services, and while the plaintiff was hired as a union carpenter by the entity, he was outside the scope of the agreement between the entity and the defendant. The judge concluded that the defendant was the plaintiff’s employer, having a direct employment relationship, supervisory authority, and the ability to hire or fire the plaintiff. As such, the court granted the defendant’s motion. The plaintiff appealed. Continue reading →

It is well-established that the Massachusetts Workers’ Compensation Act affords people the right to seek workers’ compensation benefits following workplace injuries. Issues in recovering such benefits can arise, however, if the employee suffers a second injury that is not work related. In a recent Massachusetts case, the court looked at what constitutes an intervening cause for the purposes of recovering workers’ compensation benefits. If you suffered injuries on the job, you should talk to a Massachusetts workers’ compensation attorney about your possible claims.

Procedural and Factual Setting

It is reported that the employee suffered injuries following a fall at work and subsequent activities, including lifting steel rebar at work the following day. The employer acknowledges the compensability of these injuries but disputes the finding that the plaintiff’s later painting activity, specifically painting his brother’s kitchen, was non-work related. The employee sought workers’ compensation benefits, which an administrative judge granted. The employer appealed, and on appeal, the reviewing board of the Department of Industrial Accidents upheld the administrative judge’s decision. The employer filed a subsequent appeal.

Intervening Causes in Workers’ Compensation Cases

The central question on appeal was whether the administrative judge applied an incorrect legal standard of intervening cause. The court explained that it would examine the administrative judge’s findings and reasoning to determine if her decision was arbitrary or capricious. Continue reading →

People involved in workplace accidents often suffer critical harm. If they suffer from a pre-existing condition prior to the accident, though, their employer may argue that their workplace injuries are not compensable. As long as their work injury constitutes a major cause of their deficits, however,  they have the right to recover damages, as explained in a recent Massachusetts case. If you were hurt while at work, you should meet with a Massachusetts workers’ compensation attorney to evaluate what benefits are available.

Case Setting

It is alleged that the employee, a fifty-five-year-old pipefitter, suffered a neck injury on December 29, 2008, while working for the self-insured employer. The injury, combined with a pre-existing degenerative condition, led to surgery and subsequent disability. The impartial medical examiner attributed 40% of the disability to the work injury and 60% to the pre-existing condition. The administrative judge, adopting the medical examiner but disagreeing with the “major cause” interpretation, ruled that the work injury was a major cause based on the evidence before him. The board affirmed this decision. The employer appealed.

Workers’ Compensation Benefits for Parties with Pre-Existing Conditions

The appeal centered on the interpretation of the “major cause” standard under the Massachusetts Workers’ Compensation Act, particularly when an industrial injury combines with a non-compensable pre-existing condition to cause the employee’s disability. The employer contended that the board erred in not treating the impartial medical examiner’s opinion as binding and that the board’s interpretation of the statutory phrase “a major cause” was contrary to the law. Continue reading →

Work place injuries often cause not only physical harm but also psychological trauma as well. In many instances, people who suffer enduring loss of function due to physical impairments may be able to recover permanent loss benefits. As explained in a recent Massachusetts case, the Department of Industrial Accidents has the authority to assess whether such benefits are warranted. If you suffered mental or physical harm while working, you may be owed benefits, and you should contact a Massachusetts workers’ compensation attorney.

Background of the Case

It is alleged that the claimant, a former heavy equipment mechanic for the employer, suffered an industrial injury to the elbow and shoulder, leading to the subsequent development of anxiety and depression. These conditions hindered the claimant from working and significantly affected his daily life, and he was awarded various benefits pursuant to the Massachusetts Workers’ Compensation Act. He later filed a workers’ compensation claim for permanent loss of psychiatric function under the Act, which was ultimately denied. He appealed.

Grounds for Awarding Permanent Loss Benefits

The sole issue on appeal was whether benefits for permanent loss of psychiatric function should be available to the claimant. To resolve this issue, the court looked at the Department of Industrial Accidents’ authority in determining the applicable edition of the American Medical Association Guides to the Evaluation of Permanent Impairment (AMA Guides) for assessing psychiatric impairment. Continue reading →

Pursuant to the Massachusetts Workers’ Compensation Act, employers must provide certain benefits to employees hurt at work, including cost of living benefits. In some instances, employers can seek reimbursement for such benefits from the Workers’ Compensation Fund. While the laws providing the right to seek such benefits do not indicate a time frame for pursuing such benefits, they nonetheless must be sought in a timely manner, as demonstrated in a recent Massachusetts ruling. If you have questions about your rights with regard to workers’ compensation benefits, it is in your best interest to meet with a Massachusetts workers’ compensation lawyer at your earliest convenience.

History of the Case

Allegedly, the University sought reimbursement from the Workers’ Compensation Trust Fund (Fund) for cost-of-living adjustments benefits paid to five employees from July 1, 2005, through June 30, 2010. The Fund denied reimbursement for payments made more than two years before the University filed its claims, citing the department regulation. The University appealed, and the administrative judge sided with the Fund, while the board reversed, contending the two-year limitation served no rational purpose. Both the University and the Fund filed cross-appeals for judicial review.

Cost of Living Benefit Reimbursements in Workers’ Compensation Cases

Under General Laws c. 152, § 34B, insurers are entitled to quarterly reimbursements for cost of living adjustment benefits, with no specified time limit for filing reimbursement claims. On appeal, the court employed a two-part test, considered the language of the statute, and considered whether the regulation could be reconciled with the governing legislation. Continue reading →

The Massachusetts Workers’ Compensation Act sets forth numerous rules regarding workers’ compensation claims and benefits for employees, employers, and insurance companies. If a party fails to comply with such rules and subsequently seeks intervention from the courts, their claim may be denied, as demonstrated in a recent Massachusetts case. If you need assistance pursuing workers’ compensation benefits following an injury, it is smart to talk to a Massachusetts workers’ compensation lawyer as soon as possible.

Procedural and Factual Background

It is reported that the plaintiff was injured while working for the employer’s landscaping company. The employee filed for workers’ compensation benefits from the insurer, which contested his claim. An administrative judge ordered temporary benefits and medical coverage pending a formal hearing, a decision both parties appealed. While the case awaited the hearing, the insurer initiated a Superior Court action to declare two insurance policies void, alleging misrepresentations. the employer did not oppose, resulting in a default judgment against him.

Allegedly, the employee responded but did not contest the insurer’s motion, leading to a judgment declaring the policies void. Using this judgment, the insurer requested dismissal from the DIA case but was denied. A second Superior Court action sought to enjoin DIA proceedings. In response, the employee requested relief from the declaratory judgment, claiming the court had no jurisdiction.

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While people who recover benefits pursuant to the Massachusetts Workers’ Compensation Act cannot pursue claims against their insurers, they can often recover damages from other sources, including, in some instances, their personal insurance policies. Whether such damages will be offset by their worker’s compensation benefits depends on numerous factors, including, in part, the terms of their insurance policies, as demonstrated in a recent Massachusetts ruling. If you were injured on the job, you should meet with a Massachusetts workers’ compensation lawyer about your options.

The Setting of the Case

It is reported that the plaintiff was a passenger in an MTA-owned van, which was involved in an accident with a vehicle driven by another motorist. The plaintiff sustained serious injuries, and he settled his personal injury claim against the motorist for $10,000, which was the maximum coverage under her liability insurance. The plaintiff had also received substantial workers’ compensation benefits related to his injuries. He subsequently filed a claim against his auto insurer for underinsurance benefits, seeking to enforce the policy provision.

Allegedly, the insurer argued that it was entitled to a contractual reduction in the plaintiff’s underinsured motorist coverage based on the plaintiff’s workers’ compensation benefits. The court found in favor of the plaintiff, and the insurer appealed. Continue reading →

Generally, employers in Massachusetts carry workers’ compensation coverage to provide benefits for any employees who sustain injuries on the job. If employers fail to comply with the terms of their workers’ compensation policies, though, they may be canceled. A policy cannot be canceled without adequate notice, however, as discussed in a recent Massachusetts case. If you were hurt at work, it is in your best interest to speak to a Massachusetts workers’ compensation lawyer to assess what benefits you may be able to recover.

Case History

It is alleged that the insurer attempted to cancel a voluntary policy of workers’ compensation insurance issued to the employer due to nonpayment of the premium. The employer never receive notice of the cancellation, however. Subsequently, the employee suffered an injury after the attempted cancellation. Under the assumption that the policy was not in force, he then sought and obtained benefits from the Workers’ Compensation Trust Fund. The Trust Fund later sought to add the employer to the proceedings, which resulted in an evidentiary hearing to determine the cancellation’s validity.

It is reported that an administrative judge conducted a hearing and concluded that the attempted cancellation was ineffective, holding the insurer liable for any benefits paid to the employee. The decision was subsequently affirmed by the board in a split decision. The insurer appealed. Continue reading →

It is not uncommon for people who are hurt on the job to ultimately resolve their workers’ compensation claims via settlement agreements. Generally, such agreements will not be set aside, with few exceptions, as discussed in a recent Massachusetts ruling. If you were injured at work, you may be owed benefits, and it is smart to meet with a Massachusetts workers’ compensation attorney about your options.

Facts of the Case

Reportedly, the plaintiff, a correction officer, was injured while performing duties at work, which led to them receiving workers’ compensation benefits from their self-insured employer, due to a permanent disability. Additionally, the plaintiff was awarded accidental disability retirement benefits by the State Board of Retirement, although these ADR benefits were offset by the workers’ compensation benefits received by the plaintiff. Before reaching a lump sum settlement, the plaintiff received combined workers’ compensation and ADR benefits amounting to about $4,300 per month.

Allegedly, the plaintiff entered into a lump sum settlement to end their workers’ compensation claim for a $10,000 payment. Following the settlement, they were only eligible to receive ADR benefits, which totaled about $2,500 per month. The discrepancy in these benefit amounts resulted from the distinct calculation methods used by the workers’ compensation and ADR systems. Thus, the plaintiff sought rescission of the lump sum settlement agreement on the basis of mutual mistake of fact. Continue reading →

The Massachusetts Workers’ Compensation Act grants injured employees the opportunity to seek compensation for workplace injuries, with the trade-off being the forfeiture of their ability to pursue tort claims against their employer due to the Act’s exclusivity provision. As explained in a recent Massachusetts ruling, this exclusivity provision not only applies to employees who received workers’ compensation claims under the Massachusetts Workers’ Compensation Act (the Act), but also to those who received such benefits under similar Acts in other states. If you were hurt in a workplace accident, it is advisable to consult with a Massachusetts workers’ compensation attorney who can guide you through the available avenues for seeking benefits.

History of the Case

It is alleged that the plaintiff sustained severe leg injuries when a deteriorated garage wall collapsed on him while he was on the residential property of the defendant. The defendant had hired the plaintiff’s employer, a landscaping company, to demolish and remove her garage. Following his injuries, the plaintiff filed for workers’ compensation benefits in Rhode Island, where he resided.

Reportedly, after initially being denied benefits by the landscaping company’s insurer, the plaintiff and landscaping company reached a settlement in Rhode Island for a lump-sum payment of $19,000. As part of this settlement, the plaintiff released the landscaping company and its insurer from further liability. The settlement did not expressly cover one of landscaping company’s principals. Subsequently, the plaintiff filed a negligence lawsuit in Massachusetts against the defendant and the landscaping company’s principal. The defendants moved for summary judgment, and the court granted their motion. Continue reading →