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Massachusetts Employee’s Workers’ Compensation Benefits Claim Barred by Prior Ruling

1323680_question_mark sxchu username 7rainsIn Massachusetts, a party may be ordered to pay financial penalties for unreasonably bringing or defending against a workers’ compensation benefits claim. In Ramona Richards v. US Bancorp, Board No. 041089-03, a woman allegedly sustained a back injury at work in December 2003. After the woman notified her employer about the injury, its insurer denied liability. In June 2007, an administrative law judge (“ALJ”) denied the woman’s request for incapacity and medical benefits following a hearing. The woman ultimately appealed her case to the Court of Appeals of Massachusetts. In May 2009, the appellate court affirmed the ALJ’s decision denying workers’ compensation benefits.

Over the course of several years, the woman continued to file a variety of claims for incapacity benefits related to her 2003 injury. Each was administratively withdrawn based on the doctrine of res judicata. This doctrine prohibits a matter from being revisited after a final judgment was issued based on the merits of a case. In January 2012, the employee filed yet another claim for incapacity benefits that she admitted was exactly the same as three of her previously withdrawn claims. After this claim was also withdrawn, the employee appealed to the senior judge, who then referred her case to the Department of Industrial Accidents for a § 10A conference.

Following a conference, the employee’s claim was again denied. On appeal, the ALJ bifurcated the woman’s claim in order to make an initial determination regarding whether it was barred by res judicata. The ALJ also sought to determine whether the claim was unreasonably brought in violation of § 14(1). After hearing oral arguments and reviewing the limited evidence offered, the ALJ stated the woman did not suffer a compensable work-related injury even though he credited her testimony stating she hurt her back. In addition, the judge found that the woman’s claim was previously decided and now precluded as a result of res judicata. The ALJ also ruled that the woman’s attorney filed the claim at issue without reasonable grounds in violation of § 14(1). Since the worker enjoyed no reasonable expectation of prevailing in her case, the judge ordered her legal counsel to pay the entire costs of the proceeding.

Next, the woman timely appealed the judge’s decision to the Department of Industrial Accidents Reviewing Board. In her appeal, the woman argued the ALJ committed error when he stated the woman’s first hearing established that her employer was not liable for her back injury. The Board disagreed and said the woman should have brought the issue of liability up on her first appeal.

The Board then dismissed the woman’s claim that § 14(1) penalties were not appropriate because the ALJ allowed the case to go to conference. According to the Board, the judge’s ruling did not provide conclusive evidence that her attorney had reasonable grounds on which to bring the worker’s claim. The Board said the standard was one of “objective reasonableness.” Additionally, the Board found that the judge’s prior rulings combined with the woman’s own statements demonstrated the ALJ did not commit error. The Board also upheld the amount of the attorneys’ fees awarded to the employer’s insurer.

After clarifying the appropriate bifurcation process, the Board ultimately affirmed the ALJ’s ruling in the workers’ compensation case.

If you were injured on the job in Massachusetts, you should discuss your rights with a knowledgeable workers’ compensation lawyer. The reliable attorneys at Kantrovitz & Associates, P.C. are available to help you navigate the process of your worker’s compensation case. To speak with a capable Massachusetts workers’ compensation lawyer, contact Kantrovitz & Associates, P.C. through our website or give us a call today at 800-367-0871.

Additional Resources:

Ramona Richards v. US Bancorp, Department of Industrial Accidents Reviewing Board No. 041089-03 (July 8, 2014)

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Photo Credit: 7rains, MorgueFile