Massachusetts Appellate Court Upholds Order Denying Modification or Termination of Workers’ Compensation Benefits

Boxes of EvidenceThe Massachusetts workers’ compensation system is designed to ensure that injured workers receive the support and compensation that they deserve for their injuries, lost wages, and medical bills. Although workers’ compensation insurers are meant to assist injured workers with adjudicating their claims in a timely fashion, they often do not act in the injured workers’ best interests and attempt to deny or terminate payment of benefits prematurely. As seasoned Boston workers’ compensation lawyers, we can help you ensure that you receive the fair treatment that you deserve. A recent workers’ compensation appellate opinion illustrates some of the issues that insurers raise on appeal in an attempt to avoid paying benefits.

In the case, the insurer appealed from a decision declining its motion to discontinue, modify, or recoup benefits that were paid to one of its employees who suffered injuries while at work. In March 2014, the employee suffered an injury to her neck and head in a motor vehicle accident that occurred during work. The insurer did not contest liability for the neck and head injuries, but the employee’s request for payment of medical expenses and treatment was denied. The worker filed a claim to recover compensation for these expenses. The insurer requested a modification of the temporary total incapacity benefits that the employee had been awarded, which the judge denied. The judge also required the employer to pay for the employee’s claimed medical expenses. The insurer appealed, and the judge once again issued an order refusing to modify the employee’s award of temporary total incapacity benefits.

The insurer asserted four grounds for reversal in its appeal. First, it alleged that the judge misstated expert medical opinions in reaching the decision to deny the modification. Second, it alleged that the judge substituted his own opinion for the opinion of the impartial medical examiner in an impermissible fashion. Third, it alleged that the court did not appropriately consider the impartial medical examiner’s opinion in reaching its decision. Finally, the insurer alleged that the court failed to identify sufficient evidentiary findings regarding the worker’s prior employment.

The appellate court began by summarily rejecting the insurer’s four grounds for appeal, but it noted that the workers’ compensation judge committed one harmless error in denying the modification. In the order, the judge noted that the employee appeared to be experiencing discomfort during the hearing, shifting her position frequently. The record was devoid of any evidence reflecting this observation or noting that the judge was observing this activity at the hearing. The appellate court noted that a judge is only allowed to consider the evidence that has been properly introduced and that his or her findings can only be based on appropriately submitted evidence. As a result, the appellate court concluded that the judge erred in not making this observation part of the record. Since it found that the observation was cumulative of other findings that the judge properly noted in the record, however, the appellate court concluded that the error was harmless. Accordingly, the appellate court upheld the order.

If you’ve been injured on the job, the dedicated workers’ compensation attorneys at the Law Office of Michael O. Smith are prepared to assist you in asserting your right to benefits and compensation. While you are dealing with painful injuries and serious disruptions in your life, we will handle all of the aspects of your claim, including gathering evidence and negotiating with the insurance company that may be trying to deny you the full benefits that you deserve. We offer a free consultation to help you determine your legal rights. Call us now at 617-263-0300 or contact us online.

Related Posts:

Massachusetts Restaurateur Sentenced for Multiple Fraud Schemes, Including Workers’ Compensation Fraud

Massachusetts Department of Industrial Accidents Issues Ruling on Proper Amount for Employee’s Average Weekly Wage

Changes in Workers’ Compensation Options Highlight Boston’s Gig Economy for Independent Contractors