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Massachusetts Workers’ Compensation Reviewing Board Considers Questions of Permanent and Total Incapacity Benefits

Under Massachusetts General Laws, an injured worker with serious, catastrophic injuries can qualify for permanent and total incapacity benefits. If an injured worker is still unable to work in any capacity after reaching maximum medical improvement, where he or she is unable to physically improve or recover even with additional surgery, that worker is entitled to benefits under the Commonwealth’s Workers’ Compensation Act. cafeteria-240407-m.jpg In King v. City of Newton, the Reviewing Board looked at an appeal filed by a self-insured employer who challenged the award of permanent and total incapacity benefits, disfigurement benefits, and reasonable and necessary medical expenses that included a motorized chair lift.

In this appeal, the focus centered on the testimony of the medical examiner and the Workers’ Compensation Judge’s (WCJ’s) method of issuing findings and accepting the evidence presented. The injured employee worked in the school cafeteria, which is a party of the Massachusetts’ town’s school system. She slipped and fell while clearing tables, hitting one of the tables and harming her right leg. She was seen by the school nurse, who applied ice to her leg, and used a cane the next day to get around. The injured school worker was then told by her supervisor to seek medical treatment. She followed up and was diagnosed as suffering from a sprained ankle and bruising of her right knee and lower left ribs. The city then began to pay her temporary total incapacity benefits.

Sixteen months after these benefits, the self-insured city filed a complaint to discontinue the temporary benefits based on the report of the employer’s examining physician. The WCJ heard that motion in addition to the injured employee’s motion for the employer to pay for a motorized chair lift. At this hearing, the judge granted the request regarding the motorized chair lift and denied the employer’s request to discontinue weekly benefits Following this hearing, the employer appealed and the injured worker was examined again, this time by an impartial medical examiner. After receiving the impartial examiner’s report, the employer moved for a finding of inadequacy regarding the impartial examiner’s report.

The Reviewing Board agreed with the employer’s assertion that the judge’s findings were inconsistent with the testimony provided by the impartial examiner. The medical examiner did not provide a diagnosis but did rule out any issues with tendonitis in the right ankle, finding that the Achilles tendon was intact. The medical examiner also acknowledged that the other complaints were related to the accident but did not provide a reason as to why those things couldn’t further improve.

The judge, in the findings, made note of the employee’s diabetic condition and that there was no proof that this was causally related to the workplace accident. However, the judge looked at the diabetes as a complication to the injured woman’s ability to recover and then made distinct findings about the “well-documented partial tear of the right Achilles tendon.” The reviewing board found that this was in direct opposition to the actual testimony and evaluation by the impartial examiner. The board sent the matter back to the hearing level for reconsideration but vacated the prior award.

The Massachusetts workers’ compensation attorneys at Karsner & Meehan are here to help you receive the benefits you are entitled to under the law. Call today for a free, confidential consultation at 508.822.6600.

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