When you file a workers’ compensation claim, your employer’s insurance company will usually be the entity that represents your employer throughout the claims process. In many instances, an insurance company will try to avoid paying benefits to an injured worker, or make decisions that don’t have your best interests in mind. As knowledgeable Boston workers’ compensation lawyers, we can stand by your side and ensure that you receive the fair treatment that you deserve.
In a recent appellate opinion, the insurer challenged a lower court decision awarding total incapacity benefits to an employee. The worker was injured as a union laborer in a series of accidents that spanned a 10-year period. The insurer accepted the worker’s claim for each accident and paid a lump sum settlement for each claim. In 2004, the worker returned to work at full capacity despite warnings from his doctors that doing so would likely result in further injuries. The man stated that he suffered moderate pain but that he took methadone and other medications on a daily basis to manage his symptoms. He also stated that he tried his best to avoid the most stressful and physically challenging jobs.
In 2012, the man reported another back injury and said that it occurred when another employee dropped a piece of construction material on his back. He was not able to return to work due to the pain, despite a note from his physicians clearing him for light duty work. The insurer did not accept liability for the claim, arguing that his claim was barred under a provision of Massachusetts’ workers’ compensation laws stating that an employee cannot recover compensation when the employee was injured as a result of his or her own willful and intentional conduct. The insurer alleged that since the man’s doctors had informed him that returning to work in full capacity would result in injuries, the man was acting willfully and intentionally. The insurer also argued that as a result of the man’s four prior injuries, he had actual knowledge that there was a substantial risk that he would suffer an injury if he returned to work against the doctor’s advice.