Massachusetts Appellate Court Reveres Decision Denying Injured Worker Compensation for Work-Related Shoulder Surgery

If you are injured on the job, it can be difficult to know when you will be fully healed or whether you will ever return to the same physical condition as before the accident. In the Massachusetts workers’ compensation system, injured employees are entitled to compensation for their medical expenses associated with the work injury. Many insurers attempt to reject certain medical expenses as unreasonable or unnecessary in an attempt to save costs. As seasoned Boston work injury lawyers, we will fight diligently to ensure that you receive the compensation that you need and deserve for your injuries.

Recently, a Massachusetts appellate court considered whether an injured worker was entitled to ongoing compensation for medical treatments associated with a left shoulder injury and a back injury that he sustained on the job. The man injured his left shoulder first and his employer’s insurance company provided benefits for this incident. Sometime thereafter, the man suffered an injury to his lower back for which he sought a new set of benefits. The employer approved this claim but eventually terminated the second set of benefits, alleging that the back injury was not the result of his occupational duties and that it involved a pre-existing injury.

The injured man sought benefits for his shoulder and back injury and the presiding judge issued an order awarding benefits only for the shoulder injury. The man underwent an independent medical examination for his shoulder injury and the conducting physician issued a report. A second independent medical examination was held to examine the man’s back injury.

In his claim, the injured man requested compensation for a shoulder surgery. The judge concluded that the man failed to make this request for medical procedure compensation and that instead, the man had only requested general benefits. The judge adopted the report from the independent medical examiner concluded that the shoulder injury resulted in a partial disability and concluding that the injured man had reached the end of his course of medical treatment. Based on these findings, the judge denied the request for compensation for the shoulder injury.

The injured man appealed pointing to language in the independent medical examiner’s report stating that a shoulder surgery would be reasonable, necessary, and causally related to the shoulder injury he sustained at work. The reviewing appellate court agreed with the injured man’s argument and found that the lower court erred in concluding that the man reached the end of his medical treatment. Based on this, the appellate court remanded the case and instructed the judge to reassess the medical evidence and to reach a new conclusion regarding the injured man’s request for medical treatment reimbursement.

If you were hurt on the job, our seasoned team of work injury lawyers is standing by to help you ensure that you receive the prompt and fair treatment that you deserve under the Massachusetts workers’ compensation system. We know how frustrating this situation can be, especially when insurance companies aren’t playing by the rules or keeping your best interests in mind. We offer a free consultation to help you learn more about our office and how we can assist you. Call us now at 617-263-0060 or contact us online.

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