Articles Posted in Workers’ Compensation

Even if you’ve been awarded workers’ compensation benefits, there is no guarantee that your benefits will continue. Employers have the option to file complaints seeking modifications of the award, which could change the amount of compensation that you receive. At Pulgini & Norton, our dedicated Boston workers’ compensation lawyers take pride in assisting clients with the claims process not only immediately after the injury but also throughout the entire claim. As a recent opinion illustrates, anticipating modifications and being ready to protect your right to benefits can make all of the difference.

The case involved an employee who suffered a right knee injury during her work as a registered nurse during November 2011. According to her testimony, the injury happened while she was providing assistance to a patient. The injury required her to take time off from work and to undergo a surgical repair for the knee. Although she returned to work, her chronic pain and associated symptoms required her to leave work in June 2012. She applied for workers’ compensation benefits, which her self-insured employer accepted.

The insurer provided temporary total disability benefits extending from December 2011 to when she returned to work, and from her last date of work and continuing. Some time thereafter, the employer filed a complaint to discontinue the temporary total disability benefits, which was initially denied. The insurer appealed, and the appeal was granted. After a series of medical examinations, testimony from vocational expert witnesses offered by each party, and a hearing, the judge adopted the vocational expert witness testimony of the employer.

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Knowing which medical treatments you can receive after suffering a work-related injury and whether it will be covered by workers’ compensation benefits can be difficult to determine, especially if you are dealing with painful symptoms. At Pulgini & Norton, our dedicated team of Massachusetts workers’ compensation lawyers has guided many Boston residents and their families through the claims process. As a recent opinion illustrates, having a seasoned attorney on your side can help you ensure that your right to compensation and reimbursement is protected.

In the case, the employee suffered a back injury during his employment at a supermarket in 1991. He underwent a surgical procedure to address the injury in 1992 and returned to work in 1993 for an electric company. He was laid off in 2009 and rehired in August 2011 to work on a large job. He was laid off again in March 2012, at which time he filed a claim seeking workers’ compensation benefits. He alleged that while no specific injury or event had caused his pain, he suffered injuries as a result of repetitive tasks like lifting and carrying.

After an initial hearing, the judge awarded the employee temporary total incapacity benefits. They did not require the employer to provide compensation for back surgery, however. The employee underwent a medical examination that the judge deemed sufficient. Neither party requested a chance to depose the expert or to offer additional medical evidence. Based on the medical report, the judge concluded that the employee suffered a work-related injury between August 2011 and March 2012. He also found that the work-related injury was the major and predominant cause of his disability despite his pre-existing back injury. The judge awarded temporary total and partial incapacity benefits and required the employer to provide reimbursement for all medical expenses. This included a November 2013 back surgery.

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When it comes to receiving workers’ compensation benefits, there are many different considerations that go into determining the amount of wage compensation an injured employee is entitled to receive. One of the biggest determinations involves assessing whether the injured worker has any pre-existing conditions affecting the same part of their body or health as the claimed work injury. To be compensable, a work injury affecting a pre-existing condition must be deemed the major cause of the claimed injury. At Pulgini & Norton, our experienced Massachusetts work injury lawyers have assisted employees with handling claims involving pre-existing conditions and ensuring that they receive the maximum amount of compensation that they deserve.

In a recent appellate opinion, the court discussed the difference between total incapacity benefits and partial incapacity benefits. The plaintiff worked as a certified nursing assistant (CNA) since 1994. In July 2013, the employee reported suffering an injury after she and another CNA transferred a patient to another hospital bed. She did not pursue treatment for her injury until August 2013. The evidentiary record contained conflicting information regarding the date that the injury occurred, but the employee filed her claim for workers’ compensation benefits on July 23 and stated that date as the date of the accident.

The lower court reviewed the employee’s claim and credited her testimony regarding how the injury happened as well as the relative events associated with the purported date of the injury. The employer’s insurance company challenged this determination, arguing that another date should have been used as the date the injury occurred. Based on the evidence in the record, the lower court rejected the insurer’s claim and set July 29 as the date the injury happened.

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In addition to receiving compensation for your lost wages, the Massachusetts workers’ compensation system provides injured workers with reimbursement for the medical expenses they incur as a result of the injury. Although this sounds straightforward, many claims become protracted when an insurance company denies payment for all or some of the medical bills that an injured employee submits. At Pulgini & Norton, our seasoned Massachusetts workers’ compensation lawyers have handled numerous claims involving disputed medical bill reimbursements.

A recent appellate opinion discusses the issue of whether an insurer must pay for certain aspects of an injured employee’s medical care. The employee suffered a neck injury during the course and scope of her employment as a cleaner and transporter. She applied for workers’ compensation benefits, and her claim was accepted. To treat her injury, the plaintiff underwent a spinal fusion procedure, which was ultimately unsuccessful. Her treating physician recommended another cervical fusion, which she accepted. A few days after her second procedure, the employee settled her workers’ compensation claim by opting to receive a lump sum settlement in lieu of weekly benefit payments.

The following year, the employee’s doctor performed a procedure on her lower back that was not related to the work injury. Roughly two years later, the employee filed a request for reimbursement of medical expenses for a pain patch that her physician prescribed to manage the pain associated with her neck injury. The employer’s insurance carrier had been paying for half the cost of the patch up until the hearing. During the hearing, the judge denied the employee’s claim for payment of her outstanding medical bills but concluded that the employer should continue paying for half of the pain patch. Both the employee and the insurance carrier appealed.

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A complicated aspect of any Massachusetts workers’ compensation claim is determining the nature and extent of the injury, especially when the claimant has prior injuries or health conditions. At Pulgini & Norton, we have counseled numerous Massachusetts residents regarding their rights following a work-related injury. As a recent appellate opinion indicates, if your employer’s insurance carrier decides to appeal any decision awarding you benefits, having a seasoned attorney on your side can make all of the difference.

The background of the case is as follows. The claimant was a plumber who suffered injuries to his neck during sleep. As a result of these injuries, the plumber underwent a procedure on his neck in 2004 and eventually returned to work. About four years later, the plumber, who had been self-employed, took a job working for a plumbing company. In 2013, the employee reported pain and stiffness in his neck after he operated a hammer drill for approximately one hour. The plaintiff sought medical treatment from a neurosurgeon.

The employer, which was self-insured, paid the employee benefit payments for a period of time. Then, the employee filed a claim seeking incapacity benefits on a continuing basis. The judge reviewing the application ordered the employer to pay the employee benefits for the time period from when he was injured and continuing. After the award, the employee underwent an impartial medical examination. The doctor determined that the neurosurgeon who originally treated the employee did not give enough weight to his preexisting neck injury and cervical spinal procedure. The employer moved to admit the additional medical testimony, which the judge allowed.

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For many injured employees, understanding the extent and duration of the benefit payments they are entitled to receive is a priority. Work-related injuries can cause a serious disruption to your daily life, preventing you from engaging in your usual work duties and affecting your responsibilities at home and elsewhere. At Pulgini & Norton, we have guided many Massachusetts work injury victims through the claims process, and we are standing by to assist you. If you are injured on the job, it is essential that you receive a fair and accurate assessment of the nature and extent of your injury. As a recent appellate opinion demonstrates, whether you are deemed eligible to return to work is critical.

In the claim, the employee worked as a full-time teacher at an elementary school art facility. She eventually retired in June 2010. In 2009, however, she started experiencing a strain in her right shoulder, which she attributed to daily tasks including drawing on the chalkboard and operating a paper cutter. On November 2, 2009, she suffered a sharp pain in her arm but did not report the incident or notify anyone about the pain or her belief that she had developed an injury as a result of her job tasks. She continued to work until the end of the school year and eventually filed a report with her employer on September 13, 2010, regarding her injuries.

After undergoing a physical exam, the employee was diagnosed with right shoulder rotator cuff tendinitis and instructed to undergo a physical therapy program. She returned to her doctor when the pain did not resolve. A new doctor began treating her, who ordered a cervical MRI. The test revealed multiple level degenerative discs and foraminal degeneration and stenosis in regions of her cervical spine. The doctor prescribed pain medications and eventually prescribed over-the-counter anti-inflammatory medication to manage her pain.

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Massachusetts statutes provide a specific, formulaic approach to calculating the amount of weekly benefit payments that an injured employee is entitled to receive. This calculation is based largely on the injured employee’s average weekly wage. A key component of any workers’ compensation claim is ensuring that you provide enough information for the claims adjuster to calculate your average weekly wage so that you receive the maximum amount of benefits to which you are entitled. As Massachusetts workers’ compensation lawyers, we have assisted many victims with protecting their rights and securing compensation. As a recent case demonstrates, having a knowledgeable attorney on your side can prevent delays in your claim.

The claimant was injured on the job when he fell from a ladder. The claimant was painting the side of a building in Springfield, Massachusetts when the accident occurred. He notified his employer, which filed a claim for workers’ compensation benefits with its insurer. An administrative law judge reviewed the claim and concluded that the claimant was entitled to receive total incapacity benefits. The ALJ also noted, however, that there was insufficient information regarding his average weekly wage.

At a hearing on the issue, the claimant indicated that he had entered into an agreement to receive roughly $1,000 from the employer to paint the home. He also indicated that he fell from the ladder on the second day of working on the project. The employer fired the man on the day after his injury and paid him $500. He also testified that he earned roughly $8,000 in the prior year for his work painting homes and that he also performed a variety of other employment occupations. Based on this evidence, the ALJ concluded that the claimant was performing seasonal work at the time he fell from the ladder. Since calculating an average weekly wage involves dividing the claimant’s earnings by 52 weeks, the ALJ concluded that his average weekly wage was $150.

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One of the most daunting aspects of a workers’ compensation claim is ensuring that you do not make any procedural errors early in the process that will have an impact on your ability to recover benefits. Consulting a seasoned Massachusetts workers’ compensation lawyer early in the process is one of the best ways to avoid the headaches that can arise from procedural mistakes, as the following recent claim demonstrates.

The claimant alleged that she suffered an injury to her back while working in December 2003. She notified her employer, which initiated a workers’ compensation claim with its insurance carrier. The carrier denied the claim, and the claimant appealed. An administrative law judge upheld the denial of medical benefits and incapacity benefits at the appeal hearing. After an additional series of appeals, the case made its way to the Court of Appeals of Massachusetts. This court affirmed the ALJ’s ruling denying benefit payments to the claimant.

In the years that followed, the claimant continued to assert claims seeking incapacity benefits regarding the 2003 injury. In each instance, the claim was withdrawn after the ALJ concluded that it was precluded based on a legal principle known as res judicata. This widely recognized legal principle holds that a matter cannot be revisited after a final judgment has been rendered after considering the merits of the action.

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Since workers’ compensation claims involve medical conditions and injuries, the consideration of testimony from treating physicians plays a pivotal role in determining whether an employee is entitled to workers’ compensation benefits and how long these payments should continue. As seasoned Massachusetts work injury lawyers, we know just how critical medical expert testimony can be in your claim. A recent case demonstrates how problematic conflicting medical testimony can be for a claimant.

The claimant alleged that he suffered injuries to his back when he was lifting a piece of equipment while working. The man said that he required back surgery and that he did not return to his usual occupation afterward. After a workers’ compensation claim was initiated, the employer accepted liability and paid total disability benefits to the employee from the day that the injury occurred forward.

Three years later, an ALJ denied a request from the employer to lower the weekly benefit payment amounts. Shortly thereafter, the claimant filed a claim seeking permanent and total incapacity benefits pursuant to § 34A. In response to this petition, the employer asked the court to issue an order alleviating it from paying any and all future benefit payments to its former employee.

One of the most common issues that we come across as Massachusetts workers’ compensation attorneys is claims involving injured workers who have pre-existing conditions. Depending on the nature of your existing injury and your work-related injury, you may be allowed to recover benefit payments for the aggravation of a pre-existing injury. A recent workers’ compensation case highlights a number of issues involved with claims concerning a pre-existing injury.

The claimant worked at a car dealership as a salesman. As part of his responsibilities, he was required to clear snow from certain areas on the dealership property. During January 2009, the employee alleged that he suffered injuries while he was getting out of a snow plow machine. About 30 days later, he sought medical evaluation for a neck injury at the local medical facility. During this time, he continued to work as a salesman at the dealership until October 2009, at which time he quit.

Then, the man applied for workers’ compensation benefits regarding the neck injury that he sustained. He also included allegations regarding back pain. The employer refuted the claim, saying that it was not responsible for the neck injury or the back injury because the fall that occurred in January 2009 was not the sole cause of the overall injuries that he listed in the claim. Next, the employee underwent a medical examination by an impartial doctor, according to § 11A. Both parties submitted supplemental medical documents to the administrative law judge before a hearing was held on the employee’s claim.

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