Massachusetts Court Discusses Medical Evidence Following a Claim Denial

Massachusetts’ Workers’ Compensation law demands that employers pay employees who sustain injuries while working benefits for their harm. A workers’ compensation claimant must demonstrate that they suffered an actual injury due to the nature of their work, which typically requires medical evidence. If a claimant fails to meet this burden and their claim is denied, they may be denied the right to submit additional evidence, as shown in a recent Massachusetts case. If you sustained harm due to a work injury, you may be owed benefits, and you should speak to a Massachusetts Workers’ Compensation lawyer as soon as possible.

Case Setting

It is alleged that the employee appealed a decision from the reviewing board of the Department of Industrial Accidents, which affirmed an administrative judge’s denial of his workers’ compensation benefits. The employee claimed that his job required more physical exertion than the employer acknowledged, which he argued entitled him to compensation for his injury. He also sought to introduce additional medical evidence, arguing that the IME was biased against workers’ compensation claimants.

Reportedly, the IME had commented during a deposition about studies showing poorer outcomes for people involved in litigation, which the employee interpreted as bias. Additionally, the employee challenged the administrative judge’s reliance on the IME’s opinion, claiming it conflicted with the opinions of other doctors, and he argued that his medical condition had worsened since the earlier examinations. Finally, the employee contested the judge’s acceptance of testimony that the employer could modify his job to accommodate his limitations.

Right to Introduce Additional Medical Evidence Following a Claim Denial

The court reviewed the administrative judge’s findings and concluded that the decision was well-supported by the evidence. The judge was not required to accept the employee’s description of his job’s physical demands and had appropriately assessed the employee’s credibility. The court found no error in the judge’s denial of the employee’s motion for additional medical evidence, as the IME’s comments did not demonstrate bias but were merely observations about general studies.

Furthermore, the court ruled that the opinions of the IME and the insurer’s doctor were not irreconcilable, as both allowed for the possibility of the employee returning to work with certain limitations. The court also upheld the judge’s decision to deny the introduction of new medical evidence, noting that the findings by another doctor did not show a significant change in the employee’s condition.

Lastly, the court found no error in the judge’s acceptance of testimony regarding the employer’s willingness to modify the employee’s job, as the evidence supported that the employee could return to his regular duties. Consequently, the court affirmed the decision of the reviewing board.

Get Advice from a Trusted Massachusetts Workers’ Compensation Attorney

Workplace injuries can entitle you to workers’ compensation benefits, but obtaining these benefits is not always straightforward. Employers might contest the connection between your injury and your job. For this reason, it is crucial to consult with an attorney if you are injured at work. Attorney James K. Meehan is a knowledgeable Massachusetts workers’ compensation lawyer who can advise you on your rights and advocate on your behalf. Schedule a confidential consultation by calling 508-822-6600 or by completing our online contact form.