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Massachusetts Workers’ Compensation Reviewing Board Decision Reviews Incapacity Benefits

When workers are injured in Massachusetts, they have access to different types of workers’ compensation benefits: temporary disability, permanent partial disability, and permanent total disability. When filing a claim for benefits under the Workers’ Compensation Act, there is no need to prove that a co-worker or employer was negligent. An injured worker must only show that there was an injury that occurred during the course of employment. This can require extensive medical testimony, and it usually involves a prediction about the effects of the injury upon the worker in the future.

1434765_94848220.jpgThe questions, “Is there anything I can do if my condition worsens?” and “What happens if my benefits run out?” may arise following an award of permanent partial disability. The Reviewing Board Decision of Tsitsilianos v. Worcester Housing Authority sheds some light on the process. In this case, the Board looks at two cases determining the award and claim of partial incapacity and total incapacity benefits under § 35 and § 34 benefits, respectively.

A Massachusetts industrial worker had previously been awarded payment of § 35 benefits, including medical bills and psychiatric treatment for an accident that resulted in bilateral trauma to his calf muscles and depression. However, the judge denied full disability, since the orthopedic physician opined that he could still perform full-time sedentary light work. After the employee exhausted his § 35 benefits, he refiled for total incapacity benefits, which were denied at conference. During an appeal, additional medical evidence regarding the worker’s physical injuries was submitted, but the judge determined there was insufficient proof of the worker’s mental health decline and denied benefits.

The Board’s analysis on appeal reflects that an employee is able to refile for total incapacity benefits following an award of partial incapacity benefits. The Board stated this employee had to show that the work-related condition worsened due to the industrial accident. The Board determined that the injured worker did not meet this requirement because he did not claim that his physical condition worsened. The injured worker in his appeal argued that the psychiatric condition had worsened and was psychologically disabled.

The Board did not feel the evidence surrounding the worker’s mental health was sufficient to show a decline in health. The examining physician found that the employee suffered depression after the 2005 accident and stated that the deep depression had lasted for the last five years or so, and that it began shortly after the accident. As this did not meet the legal requirement established in Foley’s Case, 358 Mass. 230, 232 (1970), the Board affirmed the judge’s prior ruling and denied total incapacity benefits.

This Board’s decision reveals the importance of experienced Massachusetts workers’ compensation attorneys who are well-versed in the law. We understand that situations change, and that you may need to seek additional benefits for a worsened physical or mental state that originated from a workplace accident. The lawyers at Karsner & Meehan will aggressively pursue all the workers’ compensation benefits to which you are entitled. For a free, confidential consultation, contact our office today at 508-822-6600.

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