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Massachusetts Appellate Court Overturns Rejection of Benefits for Shoulder Injury Based on Pre-Existing Injury Doctrine

If you get hurt while you are working, you can file a workers’ compensation claim to receive benefits for your lost wages and reimbursements for your medical expenses. The claims process can be overwhelming and stressful for some injury victims, especially if they are dealing with painful injuries and major disruptions in their lives. The more complicated your injuries are, the more complicated your claim may be, too. And if you suffer from any pre-existing injuries the insurance companies may try to claim that you are not eligible for benefits because your work injury is not the primary cause of your pain. One of the best ways to protect yourself and make sure that you get treated fairly is to consult with a Boston work injury lawyer. At Mass Injury Group, we are standing by to assist you with a free consultation.

Recently, an injured employee filed a claim for benefits stating that he suffered two separate work accidents that left him with injuries. The first accident affected his shoulder and the second affected his back. He filed a claim for benefits, which his employer’s insurance carrier accepted. It paid benefits to make up for his missed paychecks and reimbursed him for medical expenses related to both injuries. A few months later, however, the insurance company stopped paying benefits. It argued that the man’s injuries were actually due to pre-existing injuries and did not relate to his job duties. It claimed that there was no way that the man could show that there was a causal connection between each injury and the tasks that he was asked to perform at work.

The injured worker then filed a claim for benefits with the Massachusetts workers’ compensation system. The judge determined that only the shoulder injury was related to his job duties. Both the injured worker and the insurer filed an appeal challenging this decision.

Next, the worker filed a claim seeking compensation for a left shoulder injury, but the judge rejected it on the basis that the employee only sought general medical expenses and did not specify a shoulder surgery. The judge also pointed to a medical report and relied on it to conclude that the employee had reached maximum medical improvement for the shoulder injury, meaning surgery was not needed. The parties filed another round of appeals.

The Massachusetts Court of Appeal reviewed the case and ultimately concluded that the left shoulder injury was related to the worker’s job duties. It also concluded that the lower court judge did not read the medical report properly. The report stated that a surgery would be beneficial for the left shoulder injury and that the injury was directly related to the worker’s job duties.

If you were injured on the job, contact Mass Injury Group today to start learning more about filing a claim for benefits and getting the maximum amount of compensation that you deserve. We offer a free consultation so that you can ask questions, learn more about how a Boston workers’ compensation lawyer can assist you, and start figuring out what your claim may be worth. Call 617-263-0060 now or contact us online to begin.

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