If you seek workers’ compensation benefits, the insurer for your employer is typically the company that handles the claim. This can be incredibly difficult, especially if the insurer does not play by the rules and attempts to avoid paying benefits and medical expense reimbursements that you need and deserve. As seasoned Massachusetts’ work injury lawyers, our team has helped countless individuals fight for their right to coverage after a devastating work injury.
In a Massachusetts court decision that came down recently, an insurance company appealed a lower court’s order requiring the company to provide permanent and total incapacity benefits to an injured worker, in addition to payments for bodily disfigurement totaling $15,000. The court additionally awarded the worker reasonable medical expenses stemming from the injury and allowed the worker to seek reimbursement for a motorized chairlift in her home.
The injury occurred when the employee was working in a school system as the person who prepared and handed out food to school students at lunch. She was cleaning the cafeteria facility when spilled food caused her to slip and fall. Her right leg was struck when she fall, resulting in a serious injury. Although she tried to resume working, she was ultimately required to go home because of the pain. A medical examination revealed that she suffered a serious ankle sprain and contusions.
The insurer appealed the award of benefits, identifying several errors. First, it claimed that the lower court made inconsistent findings, mischaracterized evidence that the independent medical examiner provided, relied on supplemental medical evidence to challenge the medical examiner’s opinion, and failed to perform a suitable analysis of the ultimate cause of the woman’s injury.
The appellate court ultimately agreed with the employer regarding some of these assignments of error. First, it found discrepancies relating to the independent medical examiner’s report regarding the issue of causation. The appellate court also stated that the lower court did not correctly paraphrase or recite the independent medical examiner’s findings in its opinion regarding the award of benefits. Specifically, the appellate court pointed to language in the report, indicating that there was not a clear explanation as to why the worker’s condition had not healed or improved while also holding that there was a clear partial tear of her Achilles tendon. This created an internal discrepancy with respect to the causal relationship between said injury and the woman’s accident.
The appellate court concluded by noting that the judge accepted medical opinions that lacked consistency. Massachusetts law allows a judge to adopt medical findings but where an inconsistency is present, the reviewing court must reverse the decision upon which the inconsistency was based. As a result of these findings, the appellate court reversed the benefits award, then remanded the case for additional proceedings to resolve the discrepancies.
If you were injured on the job, our diligent team of experienced Massachusetts work injury lawyers is prepared to help you fight for your right to benefit payments. We will patiently answer your questions and ensure that you understand your legal rights along each step of the claims process. We offer a free consultation to help you learn more about our firm and how we can help you. To set up your appointment, give us a call at 617-263-0060 or reach out to us online.