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Massachusetts Court Discusses Determination of Total Disability in Workers’ Compensation Claims

Workplace injuries not only cause physical harm, they often inhibit a person’s ability to earn an income as well. Most employers carry workers’ compensation insurance, however, which provide wage loss benefits to employees injured in the workplace in certain instances. As recently explained by the Appeals Court of Massachusetts, however, wage loss benefits are meant to replace income lost due to a workplace injury and an injured employee will not be eligible for such benefits if he or she is able to earn more than he or she earned prior to the injury. If you suffered a workplace injury and can no longer earn an income, it is critical to retain a knowledgeable Massachusetts workers’ compensation attorney to help you pursue any benefits you may be owed.

The Claimant’s Injury and Workers’ Compensation Claim

It is reported that the claimant suffered a work-related injury in January 2013. He underwent physical therapy, after which he attempted to return to work but claimed that he was unable to perform the functions of the job. The employer’s workers’ compensation insurer paid the employee total incapacity benefits initially but filed a request to discontinue the benefits. Subsequently, in July 2015, an administrative judge granted the insurer’s request. The judge found that the claimant was partially disabled but was able to return to light duty work at least three-quarters of the hours he previously worked. Additionally, the judge found that three-quarter time work exceeded the stipulated weekly wage, even at minimum wage. Thus, the judge terminated the claimant’s total incapacity replacement benefits. The claimant appealed.

A reviewing board then vacated the administrative judge’s decision and recommitted the case for further review, due to the fact that the administrative judge did not review the claimant’s medical documents. The administrative judge then reviewed the medical documents, and once again denied the claimant’s wage loss claim. The reviewing board then affirmed the judge’s decision.

Determination of Total Disability

In Massachusetts, whether a workers’ compensation claimant has suffered a total disability is a question of fact. As such, a reviewing board’s determination on the issue of an employee’s disability must not be disturbed unless it is not supported by the evidence. In the subject case, the appellate court found that the reviewing board properly affirmed the administrative judge’s determination that the claimant was able to work enough to earn his average weekly wage.

The court noted that the administrative judge’s ruling was based on medical evidence produced by the insurer that the judge found to be credible. Specifically, the judge relied on three separate expert reports that all stated the claimant was not totally disabled. The judge was not required to find all of the medical evidence presented to be credible, however, and it was within his discretion to discredit the claimant’s medical expert. Accordingly, the court found that the administrative judge’s finding that the employee was not totally disabled was supported by the evidence.

Speak with a Skilled Massachusetts Workers’ Compensation Attorney About Your Case

A workplace injury can cause both physical and financial harm. If you were injured in the workplace you should speak with a skilled Massachusetts workers’ compensation attorney regarding what benefits you may be able to recover. The seasoned workers’ compensation attorneys of Karsner & Meehan will work diligently to help you seek a successful outcome under the facts of your case. We can be reached at 508-822-6600 for a free and confidential consultation.