The Massachusetts workers’ compensation system is designed to ensure that injured workers receive the support and compensation that they deserve for their injuries, lost wages, and medical bills. Although workers’ compensation insurers are meant to assist injured workers with adjudicating their claims in a timely fashion, they often do not act in the injured workers’ best interests and attempt to deny or terminate payment of benefits prematurely. As seasoned Boston workers’ compensation lawyers, we can help you ensure that you receive the fair treatment that you deserve. A recent workers’ compensation appellate opinion illustrates some of the issues that insurers raise on appeal in an attempt to avoid paying benefits.
In the case, the insurer appealed from a decision declining its motion to discontinue, modify, or recoup benefits that were paid to one of its employees who suffered injuries while at work. In March 2014, the employee suffered an injury to her neck and head in a motor vehicle accident that occurred during work. The insurer did not contest liability for the neck and head injuries, but the employee’s request for payment of medical expenses and treatment was denied. The worker filed a claim to recover compensation for these expenses. The insurer requested a modification of the temporary total incapacity benefits that the employee had been awarded, which the judge denied. The judge also required the employer to pay for the employee’s claimed medical expenses. The insurer appealed, and the judge once again issued an order refusing to modify the employee’s award of temporary total incapacity benefits.
The insurer asserted four grounds for reversal in its appeal. First, it alleged that the judge misstated expert medical opinions in reaching the decision to deny the modification. Second, it alleged that the judge substituted his own opinion for the opinion of the impartial medical examiner in an impermissible fashion. Third, it alleged that the court did not appropriately consider the impartial medical examiner’s opinion in reaching its decision. Finally, the insurer alleged that the court failed to identify sufficient evidentiary findings regarding the worker’s prior employment.