Published on:

Massachusetts Court Discusses Evidence Needed to Establish Causation in Workers’ Compensation Claims

In Massachusetts, when a person injured at work seeks workers’ compensation benefits, he or she must prove the elements of his or her claim, which includes establishing that his or her injury was caused by a work-related incident. Recently, the Appeals Court of Massachusetts discussed whether an administrative judge is required to adopt the opinion of an impartial medical expert with regard to causation, in a case in which the claimant appealed the denial of his request for benefits. If you sustained work-related injuries, you may be entitled to workers’ compensation benefits and should speak with a skilled Massachusetts workers’ compensation attorney regarding what evidence you must produce to recover damages.

Facts Regarding the Claimant’s Injury

Reportedly, the claimant injured his hip and back when slipped on wet plywood while employed as a laborer for a roofing company. He stated he slid down the roof but did not fall off, due to a safety harness. He continued to work the remainder of the day, passing shingles to other workers. He was twenty-six years old at the time of the incident. Two days after the incident, the claimant accepted an offer from the roofing company to shovel snow and subsequently shoveled snow throughout the winter.

Allegedly, the claimant began experiencing back pain shortly after the incident but did not seek treatment for over a month. He subsequently stopped working five months after the incident and filed a workers’ compensation claim against the roofing company, and because the roofing company was not fully insured, against the workers’ compensation trust fund. The claimant was denied benefits, after which he presented his claims to an administrative judge.

It is reported that prior to the hearing before the administrative judge, the claimant was examined by an impartial medical examiner, who noted that the claimant was a poor historian and failed to answer simple questions properly. The examiner concluded, however, that the claimant suffered a lumbosacral sprain that was caused by his slip and fall incident. The examiner also reported that the claimant was temporarily totally disabled. The judge denied the claimant’s claims as well, after which he appealed.

Evidence Required to Establish Causation

Under Massachusetts law, a report from an impartial medical examiner is considered prima facie evidence of the matters contained in the report. Further, unless conflicting evidence is presented, an administrative judge must except a medical examiner’s report as true. The court stated, however, that the judge is not required to give the report credence if he or she does not believe the factual basis of the report. The court also noted that a report should be regarded as prima facie evidence if it is supported by evidence.

In the subject case, the court noted that the administrative judge properly refused to adopt the medical examiner’s opinion, due to the fact that it was based on defective data. The court also rejected the claimant’s argument that the administrative judge improperly substituted his opinion for that of the examiner, finding that the judge merely assessed the examiner’s credibility. Thus, the court affirmed the judge’s ruling.

Meet with a Trusted Workers’ Compensation Attorney

While in some cases it is obvious that an injury is work-related, in other instances the cause of an injury is disputed, and the injured party must prove sufficient evidence to establish that his or her harm is work-related. If you were injured at work, you should meet with a trusted workers’ compensation attorney to discuss whether you may be able to recover benefits. The proficient attorneys of Karsner & Meehan are adept at navigating the process of recovering workers’ compensation benefits and will work diligently to help you recover any benefits you may be owed. You can reach us via our online form or at 508-822-6600 to schedule a confidential and free meeting to discuss your claims.