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Massachusetts Department of Industrial Accidents Reverses Decision Awarding Benefits to Employee Injured in Slip and Fall Accident, Based on Lack of Sufficient Evidence

When you are injured at work, you can file a claim for workers’ compensation benefits. Massachusetts law requires certain employers to carry workers’ compensation insurance, which means that an insurance company will typically be the entity that handles your claim. This can create some headaches, especially considering that most insurance companies do not have injured workers’ best interests in mind. The seasoned Boston work injury lawyers at the Law Office of Michael O. Smith are prepared to help you fight for your right to compensation following a work injury.

The Massachusetts Department of Industrial Accidents recently decided a case involving an insurer’s refusal to pay benefits to an injured worker. The woman in the case was working as a certified nursing assistant when she fell down a staircase at work. The insurer that her employer was using at the time of the accident accepted liability for the claim and paid total incapacity benefits. The worker then received treatment for her injury, which the insurance company also covered. The woman next indicated that she was suffering pain in her right shoulder and attributed it to the fall.

The woman later discontinued working, and the insurer stopped paying benefits. Some time later, she decided to resume working and accepted a job as a certified nursing assistant, but she was only able to work for a few days because she found the requirements of the job to be too demanding based on her disability. She also took a job providing private in-home care, but she discontinued this position as well.

The woman later received surgery on her shoulder to try and relieve her pain and discomfort, but she did not report an improvement afterward. She then sought additional workers’ compensation benefits from the first insurer, as well as medical expenses payments. The judge denied this claim. After receiving another medical examination, the woman re-filed her claim for benefits with the insurer for her second and third employers. The judge rejected this claim on the basis that her injury did not occur during her employment with the second and third companies and that she did not suffer a new injury that would constitute an exacerbation of a pre-existing condition. Instead, the judge concluded that the right shoulder condition was causally related to her original injury from falling down the staircase. Because of this connection, the judge ordered the first insurer to pay workers’ compensation benefits.

On appeal, the court reversed the finding, noting that the first insurer may not be required to pay for the right shoulder injury and stating that more proceedings were necessary to determine whether the right shoulder injury was causally linked to the first injury or whether it was a new injury.

If you suffered an injury at work, our seasoned team of Massachusetts workers’ compensation lawyers is prepared to help you assert your right to compensation. Don’t let an insurance company bully you out of the payments that you legally deserve. Call us now at 617-263-0060 or contact us online to set up a free consultation to learn more about your options and how we can assist you.

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