Massachusetts Workers’ Compensation Law Requires Proof of Inability to Earn Wages to Show Permanent Disability

While many injuries sustained at work are minor, some workplace injuries cause permanent disabilities that leave the injured employee unable to earn a living. Under Massachusetts workers’ compensation law, you must prove that you are unable to earn wages of any kind to show that you are permanently disabled. If you do not present sufficient evidence of your permanent disability, you will be denied compensation. In Rivera’s Case, the Court of Appeals of Massachusetts held that simply showing an employee is unable to return to his prior employment is insufficient to show the employee was unable to earn wages in any position. If you were injured at work, it is important to consult with a seasoned workers’ compensation attorney in your pursuit of workers’ compensation benefits, to ensure your case is properly handled.

Facts of the Case

In Rivera, the employee injured his knees breaking up a fight at work in 1996, and subsequently underwent bilateral knee surgery. He received total incapacity benefits from his employer until he returned to work in 2006. In 2011, the employee then sought additional treatment for his left knee and filed a claim for benefits to enable him to undergo an evaluation. An administrative judge set forth a conference order stating employer was required to pay for the evaluation. The employee then underwent an MRI of his knee and an orthopedic surgeon recommended the surgery. The employer appealed the conference order but at the same time issued a utilization review approval of the suggested surgery. The employee underwent surgery, for which the employer denied coverage. The employee was out of work from March 13, 2012 through June 18, 2012, for which he filed a claim for benefits. The employer then paid for the surgery and medical services, but did not offer total incapacity benefits for the period of time the employee did not work.

The employee had a hearing in front of an administrative judge for the Department of Industrial accidents, after which the judge determined the employee was totally disabled following the surgery, and ordered the employer to pay disability benefits for the period of time the employee was out of work, as well as a penalty for refusing to pay the benefits without a reasonable basis. The employer appealed and the reviewing board reversed the administrative judge’s order. On further appeal, the Appeals Court of Massachusetts affirmed the reviewing board’s decision.

Ruling of the Appeals Court of Massachusetts

On appeal, the court stated the administrative judge’s decision was contrary to the law, because the employee did not prove the permanency of his impairment. The court stated the employer was only required to pay total disability benefits for a “total and permanent” incapacity for work, which meant all work, not just work in the employee’s former position. As none of the evidence set forth by the employee addressed his ability to earn wages, the court ruled he did not meet the burden of proving his permanent incapacity. As such, the court affirmed the reviewing board’s order.

Meet with a Massachusetts Workers’ Compensation Attorney

If you suffered injuries in the course of your job duties, you may be able to recover be workers’ compensation benefits. It is in your best interest to retain an attorney skilled at managing workers’ compensation claims to analyze your case as soon as possible. The workers’ compensation attorneys of the Law Office of James K. Meehan have the experience to help injured workers recover the benefits to which they are entitled.  For a free, confidential consultation, contact our office at 508-822-6600.

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Massachusetts Court of Appeals Holds a Workers’ Compensation Insurer Is Not Barred from Re-Litigating Facts Determined in a Prior Proceeding  September 6, 2018, Massachusetts Injury Lawyers Blog

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Massachusetts Supreme Court Reviews Difference Between an Employee and Independent Contractor in Workers’ Compensation Claim  May 14, 2018, Massachusetts Injury Lawyers Blog