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Massachusetts Appellate Court Discusses the Role of Evidence in Determining Causation Where Injured Worker Has a Pre-Existing Condition

In a workers’ compensation claim, evidence plays an important role. There are many different types of evidence that can be considered, including doctor’s exams and testimony from the injured worker. This information is used to help the judge assigned to your claim to determine whether you are entitled to benefits and the amount of benefits that you should receive. Although this sounds straightforward, there are often disputes about the types of evidence that a judge should consider and whether the judge had enough evidence to support his or her final ruling. The Boston workers’ compensation lawyers at Mass Injury Group are available to assist you with learning more about the claims process and whether you are entitled to compensation.

In a recent case, the Massachusetts Court of Appeal was asked to evaluate a claim in which the injured worker suffered an elbow injury while working as a flight attendant. She was unable to work in a full-time capacity for 18 months. At that time, she stopped working due to the pain. She filed a claim for medical expenses reimbursements, but the insurance carrier for the airline denied on the basis that there was an issue with causation. The insurer argued that the medical treatment and elbow injury were not directly related to her job duties as a flight attendant. The judge presiding over the claim disagreed with the insurer and ordered it to pay for the medical treatment. The insurer appealed.

As part of the process, the worker was required to undergo a medical examination from a neutral doctor. The insurer then accepted liability for the accident. The doctor stated in the resulting report that the worker was suffering from the aggravation of an underlying degenerative disk disease as well as other injuries and symptoms. The report noted that the repetitive tasks that the worker performed were the entire cause of some of the medical issues that the worker was experiencing.

One year later, the insurer filed a request to discontinue paying benefits on the basis that the worker’s disability was no longer related to her job duties. A neutral doctor examined the worker once again and concluded that her injuries at the time were not related to her occupation or the elbow injury. The court ultimately denied the request for discontinuation, however, and based its decision on the original report. The insurer appealed.

The reviewing court reversed the lower court’s opinion. It concluded that the court should have given more weight to the second report. Where causation is being challenged on the basis that the plaintiff is suffering from a pre-existing condition, the party requesting benefits has a heightened standard of proof. A medical opinion must specify the degree to which different causes have contributed to the overall injury.

If you were hurt at work, Mass Injury Group is standing by to help. Our team of workers’ compensation attorneys has assisted with numerous claims involving a wide variety of injuries. We offer a free consultation to help you learn more about the workers’ compensation system and whether we can assist you. Call today at 617-263-0060 or contact us online to get started.

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