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Massachusetts Workers’ Compensation Judge Failed to Consider Parties’ Additional Medical Evidence at Hearing; Reviewing Board Vacates Decision Denying Employee Benefits

Addressing the denial and dismissal of an injured employee’s claim for workers’ compensation benefits, the Massachusetts Department of Industrial Accidents Review Board stated the rule that a judge’s decision must be based on all of the evidence received from the parties at a proceeding. Since the judge in this case had not considered all of the medical evidence, which was submitted by the parties but mistakenly not entered into the system by the judge, the Board vacated the judge’s decision.

The workplace incident in this case occurred when an employee, working as a cook and a laborer for a restaurant, slipped and fell off a ladder.  After landing on his back in July 2013, the employee went to the hospital, where he received treatment and was released.  A few months later, he returned to work for two days but was sent home due to his inability to perform his job. He remained out of work at the time of the appeal.

The workers’ compensation insurer for the employer paid the employee’s § 34 benefits and then filed a complaint to modify or discontinue the benefits. The judge essentially allowed for a discontinuance, since he ordered a closed period of  § 34 benefits, from January 2014 to July 2015.  The employee appealed and underwent a medical examination according to § 11A in August 2015.

The employee was allowed to join a claim for § 34A benefits, but the judge denied a motion he filed to strike the medical examination report.  At the hearing, the parties submitted 13 entries of additional medical records in a joint exhibit. The record closed in March 2016.

Issues before the judge at the hearing included whether to continue the employee’s benefits after the date of the closed period, July 2015, and whether to award the claim for § 34A benefits.  In his March 2016 opinion, the judge stated that the medical evidence included the insurer’s reports from 2014 and 2015 and that the employee’s notes and diagnostic tests were “old,” from 2012-2014. The most recent note submitted by the employee, according to the judge, was dated August 2014.

The judge determined the employee was partially disabled, able to work 75% light-duty work.  He found that the employee was not entitled to § 35 partial disability benefits.  In his findings of fact, the judge reiterated that the most recent total disability opinion provided by the employee was over 19 months old.

On appeal before the Board, the employee contended that the decision must be vacated because the judge had not considered the joint exhibit that had provided additional medical evidence and had been submitted at the March 2016 hearing.  He argued that the joint exhibit contained medical evidence that demonstrated his disability, in the form of medical opinions from 2015 and 2016.

In their opinion, the Reviewing Board stated that the file did not contain the “joint exhibit,” dated March 2016.  Despite the fact that the parties submitted this exhibit at the hearing, the exhibit was not contained in the Board file.  The Board made clear that the parties are responsible for checking OnBase to ensure that their documents are contained in the Board file. But in this situation, some of the exhibits had been entered into OnBase after the decision was written.

Next, the Board stated that when a judge receives evidence at a proceeding, that judge is required to ensure the evidence has been entered into OnBase before the judge files the decision. On the day the judge issued his decision, none of the hearing exhibits were in the board file. The Board stated that since the judge erroneously stated the last disability note the employee submitted had been in August 2014, it was clear he had not seen the additional medical evidence submitted at the hearing.

The Board held that the circumstances required vacating the decision and recommitting for the judge to review the missing evidence and make further factual findings and rulings of law.

At the Boston Law Offices of Attorney Michael O. Smith, we help injured workers pursuing benefits for work-related injuries. We are prepared to provide experienced legal representation and personal service, helping you seek compensation for lost wages from work and medical costs. Contact a skilled Boston workers’ compensation attorney regarding your claim by calling our office today.  We offer a free consultation and can be reached at (617) 263-0060.

More Blog Posts:

Massachusetts Reviewing Board Holds that Judge’s Modification of Benefits Award was not Grounded in Medical Evidence, Boston Workers’ Compensation Attorney Blog, January 3, 2017

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

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