Articles Posted in Workers’ Compensation

In a workers’ compensation claim, medical experts are often used to help the administrative law judge determine many aspects of the issues involved, including the nature of the employee’s injury, whether the injury was completely a result of the worker’s job duties, and whether the condition will resolve over time. At Pulgini & Norton, our experienced team of Massachusetts workers’ compensation lawyers has handled numerous claims on behalf of injured workers and assisted them with ensuring that they receive the maximum amount of benefits that they deserve.

In a recent appellate opinion, the court discussed administrative law judges’ ability to rely on and adopt a medical expert’s opinion. The worker in the case was a man in his 50s working as a laborer with heavy equipment for the City of Pittsfield. The man claimed that he suffered a back injury while operating road equipment during 2008. Roughly one year later, he suffered another work-related injury. In 2012, he underwent a spinal surgery procedure.

The man then had an examination with a neutral medical doctor, but the administrative law judge ruled the exam insufficient due to the complexity of the medical issues involved. Sometime thereafter, the employer accepted liability for the second injury but claimed it stemmed from a pre-existing injury and other medical conditions. After another hearing, the administrative law judge concluded that all of the man’s injuries were related to his workplace activities. The employer was ordered to pay benefits to the man as a result.

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Employers have a legal responsibility to abide by Massachusetts workers’ compensation laws. Despite these clear mandates, many employers try to cut corners or to bend the rules to avoid having to pay for workers’ compensation benefits in the event that an employee becomes injured. The Massachusetts workers’ compensation lawyers at Pulgini & Norton have guided numerous injured workers through the claims process while helping them ensure that they are treated fairly by employers and insurers alike. According to a report produced within the last five years, the Massachusetts Insurance Fraud Bureau (MIFB) concluded that a wide number of employers misreport the number of workers that they have in their employment, or misclassify an employee to reduce the requirements that they must meet for workers’ compensation premiums. The report also shows that employers typically are quick to revise their classification in the event that one of the previously misclassified employees suffers an injury.

This report is not alone in its findings. The Massachusetts Department of Industrial Accidents researched employers’ use of misclassifications and found that as many as 250,000 workers are not classified appropriately by employers. It also found that roughly 13 percent of employers in Massachusetts engage in some type of misclassification. During 2013, there were roughly 6,000 business operations that were investigated regarding their workers’ compensation compliance and insurance coverage. As a result of these investigations, over one-third of the businesses involved were mandated to cease operations, and a total of $1.3 million in fines were assessed against non-compliant employers. Also, employers involved in the investigations added 6,000 or more employees to workers’ compensation insurance policies.

Harvard Law School has also investigated this issue. It concluded that 15 percent of workers in the construction industry are improperly classified as independent contractors. The employers list them as non-employees to prevent having to pay workers’ compensation benefits in the event that the worker becomes injured. Additionally, many employers do not provide accurate information about the risks that their workers face on a daily basis. This is in an effort to prevent having to pay higher premiums for workers’ compensation insurance. The MIFB conducted investigations of almost 400 allegations of insurance fraud and determined that in 10 percent of those cases, the employer was not complying with the regulations. The investigation resulted in convictions of seven individuals and restitution in the amount of $300,000. In the same time period, a Massachusetts task force amassed in excess of $21 million in missed tax income that resulted from employers’ failures to follow the rules.

When you are injured at work and deemed eligible for benefit payments, you have the option of requesting a lump sum settlement instead of weekly or periodic payments. This is a decision that should not be taken lightly. As experienced Massachusetts workers’ compensation lawyers, we have guided many injured workers through the claims process and helped them determine a strategy to maximize their recovery.

In a recent appellate opinion, the court considered whether accepting a lump sum payment affects the injured employee’s ability to appeal the amount of benefits awarded to the employee. The employee in the case was a materials handler who suffered an injury to his left arm while working. After filing a workers’ compensation claim with his employer’s insurer, the man received weekly benefit payments based on a $400 average weekly wage for a specific period of time. During the next four years, the employee changed jobs many times and eventually took work at a stable. He also claimed that his prior work injury still caused him pain. He did not suffer a new workplace injury but instead sought medical treatment. He eventually ceased working and did not return to work as a result of the pain he was experiencing. When he ceased working, his average weekly wage was determined to be $265. The worker filed a new claim for benefits, and the original insurer that provided benefit payments joined the action. The insurer claimed that the new job that the worker held created the basis for a new work injury.

The employee underwent a neutral examination by a doctor, and the doctor’s report was admitted as evidence in the new claim. The parties were also allowed to submit additional evidence, due to the complex medical issues in the case. Considering the report and the parties’ evidence, the judge concluded that while the employee was totally disabled at first, he was now capable of performing light-duty work. Based on this, he was awarded total disability benefits from the date that he ceased working and ongoing. The judge also determined that the man could earn roughly $64 per week and that his average weekly wage was $265. At the conclusion of this hearing, the worker requested a lump sum settlement from the insurer. He then filed an appeal.

If you are injured at work, you may be entitled to workers’ compensation benefits. There are many procedural steps that are involved in securing your right to compensation, which can include payment for medical expenses associated with your injury as well as benefits to offset the loss of your wages. As seasoned Massachusetts workers’ compensation lawyers, we have guided many injured workers through the claims process. A recent case demonstrates how a court may go about calculating the amount of weekly benefit payments you may be entitled to receive.

In the case, the employee was a registered nurse and provided in-home patient care for her career. She also worked as a charge nurse. Information presented in the claim indicated that she did not have experience with computers. It also revealed that she maintained her own business as a dance instructor. In 2004, the claimant suffered a broken ankle while working as a nurse, and she was unable to return to her nursing job. She did, however, return to dance instructing, which she was capable of doing while seated.

During a hearing regarding the determination of whether the employee was entitled to benefits, the judge concluded that the employee’s injury was a direct result of her employment duties. The judge also concluded that the woman experienced left knee pain as a result of the injury that limited her to performing only sedentary work. The judge determined that the employee could perform office work as a nurse or review files at a rate of roughly $20 per hour for 32 hours per week. The judge then awarded the employee benefit payments of $187.20 per week, based on the finding that the worker could still find gainful employment. The worker appealed.

There are many aspects of a workers’ compensation claim when it comes to calculating the amount of benefit payments and reimbursements that you are entitled to receive. Although the workers’ compensation system provides compensation for any medical expenses incurred regarding the accident, many insurance companies attempt to dispute the amount of expenses that you claim, attempting to describe them as either unreasonable or not necessary. As dedicated Massachusetts workers’ compensation lawyers, the attorneys at Pulgini & Norton have assisted many injured workers with ensuring that they receive the full amount of compensation that they need for their medical costs.

A recent Massachusetts court decision discusses this issue. The injured worker in the case experienced a left elbow injury as a result of repetitive motions. She underwent multiple surgeries to address the issue, but they were unsuccessful and left the employee with nerve damage. She then developed complex regional pain syndrome as well as other conditions. The employee accepted a lump sum settlement in 1999 for her injury, which included a provision requiring the insurer to pay reasonable, necessary, and related medical expenses. In 2000, the worker began taking pain medications to help manage her symptoms, including Vicodin and Fentanyl.

The employee obtained a new degree and began working for a different employer in another capacity. In 2009, she suffered injuries in a non-work-related accident and developed a pain issue in the affected leg. She was then prescribed Lyrica in addition to the Vicodin and Fentanyl.

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Just like a civil claim for personal injuries, workers’ compensation claims are subject to statutes of limitations. In other words, there are certain time limits that apply to when you must file your claim for benefits. If you fail to file by the expiration of the statute of limitations, you are precluded from pursuing compensation. As seasoned Massachusetts workers’ compensation lawyers, we have assisted many injured workers with asserting their claims before the statute of limitations expires.

A recent decision from a Massachusetts court discusses the application of a statute of limitations in a claim for work injury benefits. The worker was employed as a nurse when she injured her neck in 2007. After receiving treatment at the emergency room, she continued to work until the pain became worse later that year. She received a discectomy and fusion procedure and did not work for four months. The worker did not apply for workers’ compensation benefits for this injury but indicated that she received short-term disability payments. She also stated that she did not report the work-related injury to her employer.

The woman sought medical treatment again in 2009 but continued to work. One evening after a long shift, she became unable to turn her head. She received treatment for this injury and did not work for three months. She received short-term disability benefits but did not apply for workers’ compensation benefits. She came back to work in 2014 but left eventually, due to her neck pain. She underwent another discectomy and fusion procedure in 2015 and did not return to work.

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The Massachusetts workers’ compensation system provides benefits and medical expenses reimbursement to employees who are injured while at work. For serious and catastrophic injuries, ensuring that you receive the compensation that you deserve can be a long and difficult process. At Pulgini & Norton, our knowledgeable team of work injury lawyers is prepared to help victims of permanent injuries seek the financial assistance that they deserve.

A recent workers’ compensation claim discusses benefits in the context of a serious injury. The employee was working in a psychiatric ward when a patient attacked him, resulting in serious injuries. The patient kicked and hit the worker in his abdomen and chest, and he also lost consciousness during the attack. The worker required substantial treatment for his injuries, which consisted of chronic lumbar and leg pain, a fractured right lower leg, deep vein thrombosis, and more. The worker was not able to return to his regular occupation as a result of the injuries.

The employee filed a workers’ compensation claim seeking a variety of benefits, including temporary total incapacity benefits and reimbursement for medical expenses. The judge assigned to the workers’ compensation claim awarded the employee a variety of benefits, including temporary total incapacity benefits. The worker suffered from a pre-existing seizure disorder as well as a degenerative arthritis condition, but the judge found that these injuries did not combine with the work-related injuries or extend the worker’s need for medical treatment.

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Work accidents can result in a wide variety of injuries. Some of these injuries heal over time, while others result in permanent disabilities, such as hearing loss. If you have been injured on the job, and you are facing a permanent or catastrophic disability, it is essential that you consult a seasoned Massachusetts workers’ compensation lawyer to help you ensure that you receive the full amount of benefits and compensation that you deserve. At Pulgini & Norton, we pride ourselves on assisting injured workers suffering from a wide variety of conditions.

In a recent workers’ compensation appeals decision, the injured worker and the employer appealed a decision that awarded the worker permanent hearing loss benefits and medical benefits. The employee worked as a laborer for the same employer for roughly 30 years. During two decades of that time, the employee worked in subway tunnels, where the work environment routinely involved screeching and deafening noises. Although these noises were incredibly harsh, the employer prohibited employees from wearing hearing protection due to safety precautions.

The worker began suffering hearing loss during 2004 and continued to experience hearing issues for 12 years. The worker retired in December 2012. After retirement, the worker sought employment elsewhere but had difficulties. He claimed that his hearing loss made him an undesirable candidate because employers saw it as a safety issue. The worker eventually obtained a temporary custodial position with the U.S. Postal Service.

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Although some work injury cases are very straightforward when it comes to diagnosing the nature and scope of the injury, there are other instances in which the medical issues can be complex. At Pulgini & Norton, our seasoned Boston workers’ compensation lawyers have handled a diverse array of work injury cases involving all kinds of accidents. The Massachusetts workers’ compensation rules allow injured workers to offer additional evidence in some instances in which the complexity of the medical issues requires a deeper analysis. Being able to offer this additional evidence to support your claim for compensation can make all of the difference in your ability to recover benefits, as a recent Massachusetts appellate opinion demonstrates.

The facts of the case are as follows. The employee worked at an electric company starting in 1980. On May 31, 2011, the employee suffered an injury when a revolving door struck his left knee. He fell at the time of the blow and suffered an injury to his left side as well. The employee saw two doctors, who treated his left knee and left hip injuries, respectively. The employee required surgery on both of his knees and was awarded weekly indemnity benefits while he recovered.

The employee filed a workers’ compensation claim, which the employer’s insurer rejected. The claim proposed a total left hip replacement surgery, alleging that the surgery stemmed from the May 31, 2011 accident. The employee appealed. As part of the appeal process, the employee saw an impartial physician, who examined the employee.

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One common question that we receive regarding workers’ compensation claims is whether psychiatric disabilities can qualify for benefit payments. There are some instances in which psychiatric injuries will qualify for compensation. As with any other injury, however, insurers often take every step they can to fight an award of benefits in the employee’s favor. As seasoned Massachusetts work injury lawyers, we know how important it is to assert our clients’ rights vigorously throughout the entire claims process.

In the case, the employee was injured at work when she slipped and fell on a set of stairs. The injury resulted in several fractures in her left foot. Her employer accepted liability for her injury, including an orthopedic injury. The employee had also filed two prior claims for psychiatric treatment. At the time it accepted the foot injury, the employer accepted liability for the psychiatric sequela. The insurer paid partial incapacity benefits to exhaustion as well as some temporary total incapacity benefits.

The employee underwent a number of surgeries on her left foot that yielded some improvement, but she still experienced pain and discomfort when walking, particularly up stairs and on uneven surfaces. She testified that as a result of her debilitating condition and the symptoms associated with her foot condition, she experienced sadness, crying, and fits of anger. After a hearing, the judge presiding over the claim concluded that the employee was permanently and totally disabled due to her foot condition as well as her severe depression arising from the accident. He awarded her the remainder of the temporary total incapacity benefits.

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