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Massachusetts Reviewing Board Holds that Judge’s Modification of Benefits Award was not Grounded in Medical Evidence

Recently, a case came before the Massachusetts Reviewing Board of Industrial Accidents that addressed a judge’s reliance upon evidence to modify a workers’ compensation order.  The rule is that a modification of workers’ compensation benefits must be based on evidence that demonstrates the employee’s medical or vocational status changed. The Board in this case reviewed the timing of medical examinations and the employee’s allegations that the judge had relied on medical opinions and findings that did not support a change in the employee’s benefits award.

The employee worked as a foreman on large construction projects and was injured when he was struck by a truck on a construction site. He fell into a trench and landed on PVC piping, injuring his shoulder, ribs, and face. After filing for workers’ compensation benefits, he was awarded temporary total incapacity benefits (section 34 benefits) from the date of the injury to September 26, 2014.  The insurer then modified his weekly benefits to maximum partial incapacity benefits.

The employee sought section 34 temporary total incapacity benefits from September 27, 2014 forward.  Then, the employee underwent his second shoulder surgery, and a section 10A conference was held 13 days later.  The insurer was ordered to pay section 34 benefits and appealed.

On June 19, 2015, an orthopedic surgeon examined the employee, and the judge found that the medical issues were complex because the surgery had taken place so close to the impartial examination date.  The insurer and the employee were allowed to submit more medical evidence following the February 12, 2015 surgery.

According to the employee, the judge committed an error when he terminated the employee’s total incapacity benefits as of June 19, 2015 (the date of the impartial examination).  The opinion issued from that examination was that the employee was totally disabled and could not return to the work force at that time.  It was September 2015 when another physician offered physical restrictions on which the judge relied in making his modification order.

In short, the employee alleged that the modification order that was tied to June 20, 2015 was not based on the evidence set forth in the record.  In order to modify an award of benefits, the employee must have a change in their medical or vocational status. The Board stated that based on the judge’s errors, and without more factual findings, they could not determine if the judge had applied proper rules of law.

Here, the Board held the judge had made findings contrary to the evidence set forth in the record, and the order modifying benefits as of June 19, 2015 was vacated. The Board recommitted the matter.

At the Law Offices of Attorney Michael O. Smith, we provide experienced legal representation for individuals pursuing workers’ compensation benefits.  If you have been hurt in a job site accident, you may be entitled to compensation for your lost wages from work and your injuries.  We offer a free consultation with an experienced Boston workers’ compensation attorney, and our office can be reached at (617) 263-0060.

More Blog Posts:

Massachusetts Reviewing Board Awards Total Incapacity Workers’ Compensation Benefits to Employee Based on Combination of Previous Work-Related Injuries and Industrial Incident, Boston Workers’ Compensation Attorney Blog, October 17, 2016

Maximum Partial Incapacity Benefits Awarded to Massachusetts Employee in Reviewing Board Decision, Based on Policy Considerations Not to Deny Benefits to Seriously Injured Workers, Boston Workers’ Compensation Attorney Blog, October 27, 2016

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