Massachusetts Reviewing Board Awards Total Incapacity Workers’ Compensation Benefits to Employee Based on Combination of Previous Work-Related Injuries and Industrial Incident

In a recent decision, the Massachusetts Department of Industrial Accidents, Reviewing Board, affirmed an award of workers’ compensation benefits on behalf of an injured employee who sought total incapacity benefits, meaning that she was unable to work as a result of her injury and requested compensation based on her average weekly wage.  The issue in this case was whether the employee’s work-related injuries were caused by an industrial accident or were a result of prior medical conditions.  According to the employer’s workers’ compensation insurer, the work-related incident did not cause her disability or need for treatment. Ultimately, the Board held the employee’s burden of proof had been met, since her prior medical conditions were in fact work-related and combined with an industrial accident, entitling her to benefits.

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From 1972 to 2011, Cheryl Briere worked a certified nurse’s assistant.  Over this period of time, she suffered injuries, some of which were work-related.  Ms. Briere hurt her back in 1994 while lifting a 350-pound man into a car.  She received workers’ compensation benefits as a result of this injury. Four years later, Ms. Briere was injured in a vehicle collision but was not absent from work as a result. Beginning in 1991, Ms. Briere worked for Lowell General Hospital.  She suffered multiple injuries, some of which she reported, and most involved injuries to her back and hips. Unfortunately, in 2004, Ms. Briere was treated for injuries resulting from another vehicle accident. She underwent hip and back pain treatment in 2005 and back and neck pain in 2008.

On the date of the incident at issue, December 4, 2011, Ms. Briere had assisted her co-workers in moving a 400-pound patient. She suffered injuries to her neck, back, and hands. She completed her shift that day and returned on the following day. Two days later, Ms. Briere sought a leave of absence. She contended that the injury she suffered from lifting the patient made it impossible to successfully perform her job.  She did not return to her employment at Lowell General Hospital.

Ms. Briere then filed a workers’ compensation claim for benefits under sections 34, 14, and 30 of the Massachusetts Workers’ Compensation Act.  She requested benefits from the date of December 6, 2011 forward.  Lowell General Hospital’s workers’ compensation insurance company filed a denial of Ms. Briere’s claim. They raised the defenses of liability, disability, causal relationship, and applicability of section 1(7A).  After a conference, the judge issued an order in favor of Ms. Briere, holding that she was entitled to section 34 benefits from December 6, 2011 forward.

After the insurance company appealed, the judge held a hearing and concluded that the lifting incident that took place on December 6, 2011 was a major cause of Ms. Briere’s disability. He then awarded her section 34A benefits. The insurance company appealed this decision.

On appeal, the Board stated that it had been an error for the judge to award section 34A benefits, since Ms. Briere had not claimed these benefits.  Instead, the Board noted, she sought section 34 benefits.  The difference between these benefits is that section 34 benefits are for total incapacity resulting from a work-related injury, while section 34A benefits refer to permanent and total incapacity.

The Board made clear that a judge is to determine only the issues before him or her.  Judges are not entitled to stray from the parties’ dispute. Here, there had not been a claim for section 34A benefits, and therefore the issue had not been tried by the consent of the parties. The Board vacated the award of these benefits on behalf of Ms. Briere.

Next, the Board concluded the evidence supported a finding that Ms. Briere had been totally disabled as a result of her work-related accident on December 4, 2011. They amended the decision and ordered that section 34 benefits should be awarded, in a weekly amount of $355.23, based on a computation of her weekly wage as $529.85. Ms. Briere would be entitled to the benefits from December 4, 2011 onward.

Lowell General Hospital’s workers’ compensation insurance company also argued that the judge had improperly discounted its defense, set forth on section 1(7A).  This defense is based on the theory that certain personal injuries are inherent in employment.  The insurance company also argued that the judge had mischaracterized Ms. Briere’s medical evidence, concluding that the 2011 industrial accident had been a major cause of her total disability.  Finally, the insurance company contended that they had met their burden of showing that Ms. Briere suffered a combination injury, partially due to her non-work-related, pre-existing medical issues.

In rejecting the insurance company’s arguments, the Board stated that when an injured employee suffers from a combination of a prior condition and an industrial accident, that employee need not meet a higher burden of proof regarding the major cause of the accident, provided the prior condition is work-related. Here, the judge adopted the medical opinions that made clear that Ms. Briere’s pre-existing issues, including sleep issues, anxiety, and orthopedic problems, were caused by her work as a certified nurse’s assistant.  Ms. Briere need not, according to the Board, meet the enhanced “major” burden of proof that is required in section 1(7A).

The Massachusetts Reviewing Board vacated the award of section 34A benefits and awarded Ms. Briere section 34 benefits, from the date of December 5, 2011 to exhaustion.

At the Law Offices of Attorney Michael O. Smith, we represent clients pursuing workers’ compensation benefits for their injuries. Following a job site accident, you may be entitled to compensation for your lost wages from work and your injuries.  Contact our office at (617) 263-0060 to set up your free consultation with an experienced Boston workers’ compensation attorney.

More Blog Posts:

Top 10 list of items to consider if you sustained a Workers Compensation Injury, Boston Workers Compensation Attorney Blog, December 7, 2015

Study finds there can be benefits for injured workers and insurers when a nurse case manager is assigned to a workers compensation case, Boston Workers Compensation Attorney Blog, June 22, 2015