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Massachusetts Appellate Court Requires Insurer to Pay for Pain Medications After Employee Accepts Lump Sum Settlement for Elbow Injury

There are many types of work-related injuries that are eligible for compensation under the Massachusetts workers’ compensation system. Some of the most obvious examples include sudden injuries like falls, broken bones, and head injuries. You can also receive compensation for injuries that develop over time as a result of repetitive tasks and motions, such as typing, stacking boxes, or cashiering. For many repetitive injuries, the pain and disabilities that result are permanent and leave the victim with a lifetime of injuries. At the Law Office of Michael O. Smith, our seasoned team of Boston workers’ compensation lawyers has handled a wide variety of work injury claims, and we are standing by to help you capture the maximum amount of benefit payments and reimbursement that you deserve.

Recently, a Massachusetts appellate court considered a workers’ compensation claim in which the injured employee suffered a repetitive elbow injury resulting in permanent pain. The injured worker reported a left elbow injury resulting from repetitive tasks that she performed at work. The injury required a number of surgeries that were ultimately unsuccessful at improving her condition. As a result of the work injury, the employee experienced ongoing nerve pain. She also developed a condition called complex regional pain syndrome. In 1999, the employee accepted a lump sum settlement, including a provision that required her employer’s insurance carrier to provide compensation for any necessary and reasonable medical expenses associated with her injury.

In the following year, the employee was prescribed a series of pain medications to help control her pain condition, including Fentanyl and Vicodin. She also earned a new educational degree and started a new job. In 2009, she was involved in an accident outside work and developed additional pain-related conditions, resulting in a prescription for Lyrica. She then sought reimbursement of these medical expenses with the original insurer and filed a claim against her second employer’s insurance company, seeking benefit payments. The administrative law judge assigned to her claim denied her request for benefits. While appealing the decision, she dropped her claim with the new employer’s insurance carrier.

On review, the court considered whether the pain medications were a necessary and reasonable treatment for her work injury, considering that she suffered a new non-work-related injury. An independent medical examination was ordered to help determine the cause of the employee’s pain and need for medications. According to the physician who performed the examination, the pain medications were a reasonable and necessary treatment for her work-related injury. The judge adopted the doctor’s findings and ordered the original employer’s insurance carrier to pay for the medications.

Understanding your rights after a work injury can be difficult, especially if your injury has accrued gradually over time. At the Law Office of Michael O. Smith, we make it a priority to treat every client with the individual and dedicated legal representation that they deserve. To schedule your free consultation with our team of Boston workers’ compensation attorneys, call us now at 617-263-0060 or contact us online.

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