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Reviewing Board Has Primary Jurisdiction Over Claims Related to Workers’ Compensation Benefits Paid to Injured Massachusetts Workers

insurance morguefile financeIn Lumbermens Mutual Casualty Co. v. Workers’ Compensation Trust Fund, an Illinois company that sold workers’ compensation insurance in the Commonwealth of Massachusetts issued a number of “second injury” benefit payments pursuant to § 37 of the Massachusetts Workers’ Compensation Law. Under the statute, insurers who make such payments may seek partial reimbursement from the Workers’ Compensation Trust Fund. During a period of eight years, the Illinois company apparently entered into a second injury payment agreement with the trust fund six times.

In 2012, the company continued to service workers’ compensation policies in Massachusetts, but it was no longer permitted to issue new policies. During this run off period, the trust fund refused to make additional second injury payments to the business because the Illinois company was no longer an insurer as defined in § 1(7). About one year later, the Illinois company was placed in liquidation.

In 2014, the insurer filed a complaint seeking enforcement of the six second injury payment agreements entered into with the trust fund. The Superior Court dismissed the company’s case and stated the claim should have been filed with the Department of Industrial Accidents Reviewing Board because it had primary jurisdiction. After that, the Illinois company filed an appeal with the Appeals Court of Massachusetts in Suffolk.

Before the appeal was heard, however, the trust fund began reimbursing insurers placed in liquidation for secondary injury payment agreements under § 37. As part of this policy change, the trust fund reimbursed the Illinois company for those payments at issue in the case. Despite this, the business filed a claim for legal fees with the Board.

According to the trust fund, the insurer’s appeal was rendered moot when it paid the company the payments on which the lawsuit was based. The appeals court disagreed and stated the issue was “capable of repetition,” and it could evade legal review whenever a payment was made.

Next, the Appeals Court examined the primary jurisdiction doctrine. The court stated the purpose of the Massachusetts workers’ compensation scheme is to protect hurt employees. Because of this, the court said any agreements that determine the amount of benefits paid to injured workers are subject to the Board’s review and approval. Despite this, the appellate court ruled that the Superior Court had jurisdiction to review a non-compensation related agreement that did not require Board approval.

After further review of the doctrine of primary jurisdiction, the Court of Appeals concluded that the Superior Court correctly held the case should have been filed with the Department of Industrial Accidents Reviewing Board. As a result, the Appeals Court of Massachusetts in Suffolk affirmed the lower court’s decision in the case.

If you suffered a workplace injury in Massachusetts, you may have the right to receive workers’ compensation benefits. The caring attorneys at Kantrovitz & Associates, P.C. are available to help you navigate the sometimes confusing process of filing your workers’ compensation benefits claim. To discuss your rights with a knowledgeable Boston workers’ compensation lawyer, contact Kantrovitz & Associates, P.C. online or call us at 800-367-0871.

Additional Resources:

Lumbermens Mutual Casualty Co. v. Workers’ Compensation Trust Fund, Mass: Appeals Court 2015

More Blog Posts:

Massachusetts Observes Workers’ Memorial Day in Honor of Employees Killed in Workplace Accidents, May 26, 2015, Massachusetts Workers’ Compensation Lawyer Blawg

Massachusetts Correctional Officer Denied Closed Period Workers’ Compensation Benefits Where Work Stress Was Not a Major Cause of Medical Symptoms, May 21, 2015, Massachusetts Workers’ Compensation Lawyer Blawg

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