Massachusetts Appellate Court Denies Request for Compensation for Nursing Home Expenses in Work-Related Amputated Leg Injury Claim

There are some Massachusetts workers’ compensation claims that are relatively straightforward and that involve injuries that heal over time. In other, more complex situations, an injured worker requires a lifetime of care after suffering an accident on the job. At the Law Office of Michael O. Smith, we have repeatedly assisted individuals throughout Boston with ensuring that they receive the full amount of compensation and benefits that they deserve after a debilitating and enduring work injury.

In a recent appeal, the Massachusetts Department of Industrial Accidents discussed whether an employer was liable for long-term care for a worker who was injured on the job. The employee was hurt when he was working as a custodian. He was working on a hot tar roof at the time the injury occurred, and he reported suffering severe blisters and burns on his left foot. He was treated immediately for these injuries, but he indicated that he still suffered serious medical consequences as a result of the incident. These included ulcers, repeat infections, and other injuries in his left foot.

The man filed a claim for workers’ compensation benefits. The judge approved the claim and deemed the worker entitled to temporary incapacity benefits. He also provided compensation for depression that the man reported suffering as a result of the injury. After these benefits were awarded, the medical professionals treating the man determined that the amputation of his left toe was necessary. Eventually, they amputated his left leg from the knee down. The employee applied for a lump sum settlement of his workers’ compensation claim, which the presiding judge approved. The employer did not contest liability for the amputation or the depression. The Massachusetts Workers’ Compensation Fund provided reimbursement for 67 percent of the expenses that the employee incurred for his medical treatment.

Roughly 14 years afterward, the worker applied for additional medical benefits stemming from his placement in a nursing home facility. Medicaid intervened, seeking reimbursement¬†for over $1 million in medical costs. The employer then joined the Trust. The injured man’s daughter testified at a hearing about the claim for reimbursement for nursing home costs as well as reimbursement for the fees associated with setting up a legal guardianship for the man. The presiding judge denied the request for additional benefits for the care facility but awarded benefits for setting up a legal guardianship.

Both parties filed appeals, and the reviewing court affirmed the lower court’s ruling on the basis that the man’s placement in a nursing home facility was not a direct result of his work injury. According to the appellate court, the record lacked any evidence showing that the employee was suddenly unable to live at home without assistance as he had done for several years prior to the application for additional benefits.

Work injuries are often devastating and complex. We have handled a wide variety of workers’ compensation claims, including complex injuries that result in permanent disabilities. Whether you are simply wanting more information about the process or you are ready to seek the benefits that you deserve, we are ready to assist you. To schedule your free consultation, call us at 1-617-263-0060 or contact us online.

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