Causation Established When Insurer Failed to Appeal Order Awarding Burial Benefits Granted by Massachusetts Judge

Massachusetts workers’ compensation is designed to help employees who suffer from work-related injuries or medical conditions.  The Massachusetts Department of Industrial Accidents, Reviewing Board, addressed benefits available to the spouse of a deceased worker.  An administrative judge had awarded the claimant (the spouse) burial benefits but denied her claim for dependency benefits. On appeal, the Board was to analyze whether the insurer had, through its failure to appeal the award of burial benefits, recognized that the worker’s death was caused by work.

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After suffering back and neck injuries at work, the employee in this case had received workers’ compensation benefits until the date of his death.  He died from excessive aspirin ingestion.  The employee was married but living apart from his spouse at the time of his death.

Since Massachusetts workers’ compensation laws provide for benefits to the spouse of a fatally injured worker, the claimant filed for benefits.  The insurer for the employer contended that she was not entitled to burial or funeral expenses, but the judge awarded her those benefits, while denying her claim for dependency benefits. She appealed.

On appeal, the claimant argued that the insurer could not argue there was no causation between the work-related injury and the employee’s death.  Since the judge awarded her burial benefits, she argued that by not appealing that order, the insurer admitted causation.  Put simply, she argued that since burial benefits are only awarded when an employee has died from work-related causes, an unchallenged award of these benefits establishes that causation.  If causation is clear, the only other issues are whether the claimant was the employee’s dependent and the amount of dependency benefits to which she was entitled.

In the ruling, the judge stated that parties are bound by rulings set forth in a conference order, if it is not appealed.  But the insurer contended that the judge did not permit them to argue the issue of causation.  The Board rejected this argument.  The Board made clear that a causal relationship is only one element of a dependency benefit claim.

According to law, the Board stated that burial benefits are appropriate when causation is shown between an employee’s death and their injury.  To be awarded dependency benefits under workers’ compensation law, the claimant must set forth causation and dependency.  Here, the Board stated the claimant appealed, but she had not carried the burden of proving all of the elements of her claim for burial benefits.  But the Board stated that since she had appealed, she did not need to prove the elements of her burial benefits claim, including the element of causation.

The Board turned to the burial benefits statute itself, stating that the larger context of workers’ compensation laws provides that those injured at work are entitled to benefits.  Burial benefits, according to the Board, include a causation element.  By failing to appeal the order awarding burial benefits, the insurer established the causal relationship between the employee’s injury and his death.

The Board affirmed the decision, awarding burial benefits to the claimant.

At the Law Offices of Attorney Michael O. Smith, we help injured individuals and their families as they pursue benefits for work-related injuries and fatalities.  If you or someone close to you has been injured in a job site accident, you may be entitled to compensation for your lost wages from work, and in the case of a fatality, your relatives may recover burial and dependency benefits. Our office provides a free consultation with a skilled Boston workers’ compensation attorney, and we can be reached at (617) 263-0060.

More Blog Posts:

Injured Employee Entitled to Continuing Benefits, Since Insurer Failed to Meet Burden of Showing Medical Condition Improved According to Massachusetts Law,  Boston Workers’ Compensation Attorney Blog, January 12, 2017

Maximum Partial Incapacity Benefits Awarded to Massachusetts Employee in Reviewing Board Decision, Based on Policy Considerations Not to Deny Benefits to Seriously Injured Workers, Boston Workers’ Compensation Attorney Blog, October 27, 2016