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Massachusetts Workers’ Compensation Reviewing Board Decision Determines Which Insurer Pays Benefits

During the course of your career, you are likely to have several different jobs under different employers. Injuries can occur at any of these positions, particularly ones that may exacerbate older injuries sustained during previous employment. Workers’ compensation insurance companies have often disagreed on who is responsible for paying benefits, especially permanent benefits. To assist with this scenario, the commonwealth’s workers’ compensation case law created the “successive insurer rule,” which requires the insurer at the time of the most recent injury that bore a causal relation to the incapacity to compensate the worker for her or his injuries.

street-painter-1468378-640x480.jpgThe Massachusetts Reviewing Board recently issued a decision in Griffin vs. Travelers Painting Co. (BD Nos. 037293-11 and 034762-13) that reviewed who was ultimately responsible for the temporary total incapacity benefits and permanent partial incapacity benefits paid to a painter who suffered serious knee injuries over the course of his work life. The painter first suffered injuries to both his knees when he fell out of a truck, and he re-injured his knee 11 days later. The employer’s insurer paid him temporary total incapacity benefits for about five months. The painter then worked for another residential painting company that had a different workers’ compensation insurer. The painter was able to work with some pain in each knee, having “good and bad days.” While working for the second employer, the knee pain increased due to the climbing and kneeling associated with the job.

After the painter was laid off, he underwent a second knee surgery that successfully reduced his knee pain in great measure. He filed for benefits from the first employer’s insurer, which then sought to add the second insurer. The first insurer felt the worsening injuries were related to work the painter performed at his second job. Much medical evidence was reviewed by the Administrative Judge at the hearing, who adopted the testimony of the treating surgeon that the knee injuries were caused by the original accident at his first job. The first insurer appealed, and the Reviewing Board took up the appeal to consider whether or not the successive insurer rule was violated.

The first insurer argued that evidence was ignored regarding the worsening condition of the painter’s knees while he worked at the second job. The Reviewing Board, looking to case law, disagreed, determining that the judge acted within his discretion by adopting the opinion of the testifying surgeon. The board specifically noted that expert medical testimony is necessary to support a finding of compensability. The board did not feel it was a problem that other medical expert testimony contradicted the surgeon’s position, since the opinion was formed by a qualified physician. The board did not find any violation of the successive insurer rule and affirmed the decision of the judge.

At the Massachusetts workers’ compensation firm of Karsner & Meehan, our lawyers work hard to maximize the benefits you are entitled to receive under workers’ compensation laws. For a free consultation, call our office at 508.822.6600.

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Massachusetts Supreme Court Ruling Allows Injured Couple to Keep Millions in Awarded Damages, Massachusetts Injury Lawyers Blog, September 28, 2015
Massachusetts Supreme Judicial Court Affirms Multi-million Dollar Verdict in Medical Malpractice Wrongful Death Suit, Massachusetts Injury Lawyers Blog, September 15, 2015