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Massachusetts Workers’ Compensation Benefits Award Overturned Because Judge Adopted Conflicting Medical Opinions

file0001097532734 morguefile mensaticA Massachusetts administrative law judge (“ALJ”) may not adopt conflicting medical testimony when awarding workers’ compensation benefits. In Loretta R. King v. City of Newton, a 62-year-old woman was employed in a public school cafeteria. In April 2010, the woman allegedly injured her right leg when she slipped and fell while cleaning cafeteria tables at work. After her fall, the school nurse applied an ice pack to the woman’s injury. The following day, the woman returned to work using a cane, and her supervisor ordered her to seek medical care. Two days after she was injured, the employee was diagnosed with a sprained ankle and bruised knee at a local hospital. Soon afterward, the woman’s employer began paying her temporary total incapacity workers’ compensation benefits.

Following a June 2011 medical examination report, the woman’s employer sought to discontinue her workers’ compensation disability benefits. During a conference regarding the matter, the employee requested that her employer pay for a motorized lift chair to be installed at her home. The ALJ considering the case denied the employer’s request to discontinue the employee’s disability benefits and ordered the employer to pay for the requested medical device. The woman’s employer then appealed the ALJ’s order.

Next, the worker was examined by an impartial physician pursuant to § 11A. Nearly 18 months later, a conference judge granted the worker’s request to join a § 36 bodily disfigurement claim to her disability case. After that, the woman’s workers’ compensation case was transferred to another ALJ. In October 2013, the ALJ allowed the woman to join a § 34A request for permanent and total incapacity benefits. In response, the employer raised “the defenses of disability and the extent thereof, causal relationship, and § 1(7A).”

At a hearing, the ALJ found that the independent doctor’s report was inadequate and allowed the parties to submit additional medical evidence regarding the cause of the woman’s disability. After reviewing the testimony and other evidence offered, the judge ordered the employer to pay the woman § 34A permanent incapacity benefits. In addition, the ALJ issued an award of $15,000 in § 36(1)(k) bodily disfigurement benefits as well as reasonable and necessary medical expenses stemming from the employee’s workplace ankle injury. Next, the woman’s employer appealed the ALJ’s decision to the Department of Industrial Accidents Reviewing Board.

On appeal, the employer argued the ALJ made internally inconsistent findings about the impartial doctor’s opinion related to the cause of the woman’s disability. In addition, the employer claimed that the ALJ misstated the neutral physician’s opinions and relied on those misstatements when she ordered that the worker receive § 36 benefit payments. After examining the record, the Board agreed that the ALJ misstated the doctor’s opinion and adopted conflicting medical testimony. Because of this, the Board ruled that the ALJ’s decision was internally inconsistent and could not stand. Since the Board could not say the error was harmless, and it was up to the ALJ to weigh the evidence offered, the Board vacated the ALJ’s decision and recommitted the case to her for additional findings of fact and rulings of law.

If you were injured in a work-related accident anywhere in Massachusetts, you may be entitled to receive workers’ compensation benefits. The hardworking lawyers at Kantrovitz & Associates, P.C. are available to help. To speak with an experienced Boston workers’ compensation attorney, contact Kantrovitz & Associates, P.C. through our website or give us a call today at 800-367-0871.

Additional Resources:

Loretta R. King v. City of Newton, Department of Industrial Accidents Reviewing Board No. 009543-10, (February 13, 2015)

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