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Massachusetts Workers’ Compensation Reviewing Board Upholds Decision Requiring Second Insurer to Pay Medical Benefits To Worker with Shoulder Injury

During the course of a career, the employing company may re-organize different aspects of its business, including its workers’ compensation insurer. Workers’ compensation law provides for this situation, in the event that a long-term worker suffers an ongoing injury with another injury. The successive insurer rule requires an insurer to pay for the compensation of all of the injuries that a worker suffers, even if it was not the insurer when the original incident or ongoing injury occurred. As long as the recent injury has a causal relation to the disability claimed, the insurer must cover the risk. The insurer must take the employee “in the condition in which he finds him,” so the provision of benefits is streamlined and expedited.

In Linton v. G.P.C. International (Bd. No. 035380-10), the second insurer appealed a decision granting medical benefits for a repetitive injury to an employee’s right shoulder. The employee worked for the employer since 1996, performing repetitive, heavy lifting of 75 to 100 pounds as a paper processor and machine operator.  work on trainHe began having pain in 2003 in his right arm, which resulted in physical therapy. Seven years later, the worker returned for shoulder pain care and could not work for two months. During this period, he received weekly workers’ compensation benefits. The first insurer paid for medical expenses, including physical therapy and a TENS unit he still uses.

A year later, after he returned to work full-time, a 75-pound box fell on the worker’s right shoulder and knocked him to the ground. He had to have more intense medical treatment and physical therapy, which was paid for by the second insurer. The employee then began to receive cortisone shots to reduce his pain and presented claims to the first and second insurers for payment of the treatments. At the hearing, the judge found that the employee continued to have work-related pain, and the accident with the box aggravated the prior injury. The judge required the second insurer to pay by assessing the injury to be a “continuum” injury because the daily work aggravated the original injury to the arm and shoulder. The second insurer argued that the judge inappropriately applied the successive insurer rule. The Reviewing Board disagreed, finding that the hearing testimony from the employee indicated that he suffered from an ongoing injury without any objection by the second insurer. The Board found no error by the judge in applying the successive insurer rule and requiring the second insurer to pay. The decision ordering the second insurer to pay the employee’s medical benefits was affirmed.

The Massachusetts workers’ compensation attorneys at Karsner & Meehan have the experience you need to pursue your benefits. Whether it is an new injury or a continuing injury, we can help you with your claim.  Call our office today at 508.822.6600 for a free, confidential consultation.

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