The Commonwealth’s Appeals Court recently issued a Massachusetts workers’ compensation decision affirming the determinations made by the Administrative Judge and Reviewing Board granting temporary and permanent benefits to a bank teller who suffered a series of back injuries at work. The employee first reported transitory back pain in 2011, but she was asymptomatic for two years following her treatment. In 2014, she had another round of back pain after lifting several coin rolls from the floor to take to a service window. The employee managed to return to work but experienced increasing back pain for several months. The employee left to treat the pain and came back, but she eventually left for good in January 2015 after the pain refused to subside.
At the hearing, the judge found the teller suffered an industrial injury in 2014, which resulted in total disability from July 12, 2014 through November 3, 2014, and again from January 2015 and ongoing. The insurer was directed to pay the compensation for those periods as well as payment for the necessary medical treatment provided. The insurer appealed, arguing the Board’s decision upholding the administrative judge’s award was arbitrary and capricious, and it was not based on the evidence provided in the record.
The appellate court found the evidence, although conflicting, supported the judge’s findings and conclusions in favor of the teller. The administrative judge found the teller’s testimony to be credible and persuasive, and he adopted her account for all of the substantive points. The submitted notes and testimony from the treating and examining physicians backed up the teller’s testimony, and the accident in March 2014 was determined “with reasonable medical certainty” to be the cause of the teller’s pain. The judge adopted the opinion of the physician who concluded the teller was unable to carry out her previous work functions. While this opinion differed from the other physician’s testimony, the court found it was within the judge’s discretion to adopt one opinion over the other.
The insurer raised an affirmative defense at the original hearing, claiming the injury partly resulted from a prior, non-compensable injury. When an affirmative defense is raised, the defendant insurer or employer has the burden to produce evidence to support its claim. The administrative judge found this burden was not met, and the appellate court agreed. The insurer pointed to the physician’s opinion that the disc herniation started before the March 2014 accident, but the judge and appellate court determined this testimony did not suggest the herniation related to or contributed to her current condition. The doctor stated at the original hearing there was no causal relationship between the diagnosis and her occupation as a teller.
The appellate court also agreed with the administrative judge’s decision to allow the addition of a third claim for benefits from January 2015 and ongoing. The motion to amend came after the initial conference, but before the hearing on the insurer’s appeal. The court did not feel this unduly prejudiced the opposing party because the new claim was based on the same March 2014 industrial injury. The court noted the insurer did not identify the prejudice the joinder had caused. The Appeals Court determined the decisions of the administrative judge and the Board affirmation were neither arbitrary nor capricious, and it affirmed the award of benefits to the teller.
Workers’ compensation insurers will attempt to minimize the benefits paid to injured employees in any way they can. The Massachusetts workers’ compensation attorneys at Karsner & Meehan have the experience you need at your side to push back against these attempts. Our office understands the financial hardship a workplace injury can cause, and we can aggressively pursue the benefits you need. For a free, confidential consultation, contact our office at 508-822-6600.
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Massachusetts Workers’ Compensation Reviewing Board Affirms Temporary Total Incapacity Benefits Award to Registered Nurse, November 16, 2017, Massachusetts Injury Lawyers Blog
Massachusetts Appeals Court Allows Estate to Pursue Wrongful Death Medical Malpractice Action, February 5, 2018, Massachusetts Injury Lawyers Blog