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Massachusetts Workers’ Compensation Board Decision Examines Line Between Total and Partial Incapacitation

Workers’ compensation benefits make a distinction between two categories – whether an injured employee was partially disabled or totally disabled, and whether the disability was temporary in nature or permanent. Benefits are calculated based on the combination the injured worker possesses. Administrative hearings are conducted to help determine which category applies, and this affects the amount of benefits received and the length of time it is provided to the injured employee.

The Massachusetts Workers’ Compensation Reviewing Board recently issued a decision that considers these distinctions. A personal care assistant suffered a workplace accident while assisting a bedridden patient. This accident caused radiating pain, beginning in Residential Careher lower back and going into her left leg and foot. She was eventually diagnosed by an impartial physician with chronic lumbar strain and left leg radiculopathy. The diagnosis also included a degenerative condition in her spine. At the hearing, it was agreed she would not be able to continue work as a personal care assistant, due to her inability to carry out the physical demands of the job.

The employee’s treating physician eventually cleared her to do light duty work “if available.” A month after that, the doctor conducted another examination and advised there was no work disposition until further workup and treatment. The judge utilized the first assessment and found the employee could perform light duty work but rejected the physician’s opinion that she could not work unless she received additional treatment. The judge adopted the opinions of other physicians who examined the employee six months prior to the treating physician’s assessment she could return to light duty. Total temporary benefits were awarded from December 2012 to September 2013 and partial disability benefits from September 2013 onward. The injured employee appealed, disagreeing with the assessment she was only partially incapacitated, based on the note regarding light duty and the physicians’ opinions given based on examinations performed six months before.

The Board agreed with the injured employee’s argument that the judge erred by basing his findings on this collection of evidence. The injured person argued the judge was to make findings regarding her ability to lift, push, pull, stand, reach, etc. and define what was meant by “light duty” in the doctor’s note. The employee argued utilizing the first note but not the follow-up determination by the same physician, created within a month of each other, was arbitrary and capricious.

The judge based his award of partial benefits on the collective opinions of the impartial physician and two Independent Medical Examiners. The impartial physician found she could not lift, carry, bend, or push/pull, and she would have to change her position from sitting every 20-30 minutes. One IME found she could perform a sedentary job as “modified light duty” as long as she avoided repetitive bending, lifting anything more than 10 pounds, or pulling, twisting, and pushing for direct patient care. The other IME found she could perform light duty with no bending, pushing, twisting, turning, or lifting anything greater than five to 10 pounds. The judge connected these assessments to the treating physician’s initial note declaring she could perform “light duty” work, without any descriptions of which limitations accompanied this ability.

The Board found it was not acceptable for the judge to impose limitations made by doctors who provided them at an earlier date onto a subsequent doctor’s opinion of light duty capacity. The employee’s ability to perform light work applied to the date these opinions were respectively issued.

The judge found the doctors’ limitations were to become effective at a later date and time, but none of their notes indicated this to be the case. The Board determined the findings to be inconsistent with each other, causing the award of partial benefits to be in error. The case was recommitted for reconsideration and new findings of fact on the partial disability award from September 2013. The total incapacity benefits were affirmed.

The experienced Massachusetts workers’ compensation attorneys at Karsner & Meehan can help you maximize the benefits you’re entitled to receive. For a free, confidential consultation, contact the office today at 508-822-6600.

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