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Articles Posted in Workers’ Compensation

In a Cape Cod workers’ compensation case, one of the most important issues is whether the worker (or “claimant”) has suffered a permanent physical impairment due to an on-the-job accident or a work-related illness. If so, the next inquiry is usually whether the impairment is such that the worker cannot return to work as a result.

The question of whether the claimant can return to work involves more than the issue of whether the injured individual can go back to the same job that he or she held at the time of the event giving rise to his or her permanent physical impairment. Rather, the question is whether he or she can return to any type of job at all – even one that he or she has never done before.

Of course, this doesn’t mean that a person who has done nothing but hard physical labor will be expected to shift into a desk job for which he lacks the requisite education and training. These matters, too, are taken into consideration. A recent case involved a related question, i.e. whether a skilled worker was totally disabled if he could still perform low-paying unskilled work.

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Under Massachusetts’ workers’ compensation laws, employees who are hurt on the job and unable to work as a result are entitled to certain benefits. Included among these is the right to temporary total disability payments.

In order to receive temporary total disability benefits, the employee must be able to show that he or she suffered a total incapacity for work during the relevant time period. For employees who qualify, the employer (typically through its workers’ compensation insurance company) is obligated to pay the employee a benefit equal to 60% of his or her average weekly wage.

Of course, such payments are subject to minimums and maximums, and there is a time limit on the receipt of such payments. Under the current statutory scheme, an employee may not receive more than 156 weeks of temporary total disability payments.

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There are several issues that routinely arise in Cape Cod workers’ compensation cases. One of these is the payment or reimbursement of the injured employee’s medical expenses.

Ideally, the employee’s medical expenses would be paid in the regular course of business following his or her accident or illness, so long as certain conditions were met (such as seeing a doctor who was approved by the employer’s workers’ compensation insurance carrier). Sometimes, however, this does not happen, and the employee must seek assistance from the court.

Even if the workers’ compensation insurance company initially refused to pay the injured worker’s medical expenses, the court may order the company to pay such expenses, either directly to the medical providers or as reimbursement to the worker (or, sometimes, to a health insurance company that paid the expenses on the worker’s behalf). Of course, there are sometimes situations in which the court finds that the workers’ compensation insurance company was not obligated to make such payments.

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Like other types of cases involving personal injury or wrongful death, Massachusetts workers’ compensation cases involve a variety of deadlines. For the injured worker, these deadlines typically include the time by which notice must be given and a claim must be filed.

Of course, there are also deadlines that may apply to others who may be involved in the administration and/or litigation of a claim for work-related injury benefits. These parties may include the employer, the employer’s workers’ compensation insurance carrier, and possibly others, depending upon the circumstances of a particular case.

It should also be noted that, while most work injury cases are resolved in a relatively short period of time (especially if there is no permanent disability to the worker), this is not always so. As the case below proves, some such cases can go on for many years.

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In a Cape Cod workers’ compensation case, the issues can be numerous. Typical issues include the amount of temporary benefits due the worker, the extent of the worker’s permanent disability, and the worker’s entitlement to medical care for his or her injuries.

Sometimes, contention begins even earlier in the process, with the employer or its insurance company denying the worker’s claim. As grounds, the employer or carrier may claim that the injury did not happen in the course and scope of the employee’s work or that some other defense (such as intoxication on the job) may apply.

In still other cases, the dispute may be even more fundamental. Was there workers’ compensation insurance in effect at the time of the accident in question?

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Most people are at least vaguely aware that there are deadlines for filing a claim in a Cape Cod work injury case. The particulars of those procedural rules, however, are not as widely understood. As the following case indicates, sometimes the statutes of limitations can even be a matter of dispute, due to the unique facts of a given case.

If you or someone in your family has been hurt at work, it is best to talk to a lawyer right away. A knowledgeable work injury attorney will talk to you about the details of your accident and advise you of the procedure for protecting your claim and your legal rights.

Waiting too long to take legal action can result in total forfeiture of an otherwise valid claim, so it important to understand the necessary steps in your particular case. It is important to note that, while there are general statutes of limitation for workers’ compensation cases, the circumstances of your particular case may alter that general timeline. This is especially true in cases involving product injury, injuries out of state, and accidents that were caused by the negligence of a governmental entity.

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A typical Cape Cod workers’ compensation case involves several different types of benefits, including medical care, temporary disability, and permanent disability. The determination of what is due an injured worker in a particular case can be a complex process. Oftentimes, there is a great amount of disagreement between the injured worker and his or her employer’s workers’ compensation insurance company regarding the benefits that are due.

Employees have a right to legal counsel during the benefits determination process. If you have been hurt and are wondering whether you should hire an attorney to represent you in your case, please keep in mind that workers’ compensation attorneys do not charge legal fees up front. Rather, your attorney’s fee will be paid out of any settlement or judgment that you receive, so that the inability to pay an attorney when you are already hurt and out of work is not a barrier.

Facts of the Case

The claimant in a recent (unreported) workers’ compensation case appealed to the Commonwealth of Massachusetts Appeals Court was woman who injured her back in mid-March of 2014 while working as a law librarian for a law firm. The plaintiff first sought medical treatment for her back injury in June 2014. She permanently left her employment in December 2014, at which time she was allegedly still suffering from pain, muscle spasms, and swelling. In September 2015, the employer’s workers’ compensation insurer filed a complaint to discontinue the claimant’s disability benefits.

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Cape Cod work injuries are common. In order to receive the benefits to which he or she is entitled, the injured employee must take several proactive steps. First and foremost, the worker must give the employee notice of the accident, injury, or work-related illness. A formal claim must also be filed within a set period of time. Having an attorney handle this aspect of the case is wise. After all, the employer and its insurance company are routinely engaged in such matters, and a worker who may be filing a claim for the first time can be at a substantial disadvantage.

Facts of the Case

In a recent case considered by the Massachusetts Supreme Judicial Court, the plaintiff was a woman who had filed a workers’ compensation claim some years prior. Her claim eventually proceeded to a hearing before the Massachusetts Department of Industrial Accidents, which approved a “lump sum agreement” in 2016. Almost two years later, the plaintiff filed a motion asking that she be granted an extension of time in which to file an appeal from the agreement previously approved by the department. An administrative law judge denied the plaintiff’s motion for an extension of time in which to appeal, as well as her motion for reconsideration.

The plaintiff then filed a notice of appeal in the Massachusetts Appeals Court, seeking review of the administrative law judge’s orders denying her motions. The court (through a single justice) treated the plaintiff’s “notice of appeal” as a motion for leave to file a late notice of appeal and denied the plaintiff’s request. The plaintiff then filed documents in a county court, seeking review pursuant to Massachusetts General Laws ch. 211, § 3. The plaintiff’s efforts to have her case reviewed by that tribunal were likewise unsuccessful.

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Massachusetts workers have certain protections under state and federal law. For instance, most workplace injury cases fall under the provisions of Massachusetts workers’ compensation laws. Generally speaking, if a worker’s injury is covered by workers’ compensation, he or she will not be able to file a negligence lawsuit against the employer or a co-worker. While there are some exceptions to this general rule, most such claims are barred under Massachusetts law. A recent case explored this concept.

Facts of the Case

In a recent appeals court case, the plaintiff was a woman who sued her former employer (a bank) and two former co-workers, alleging that she had suffered personal injuries due to the defendants’ creation of a “toxic work environment” and asserting claims for negligent retention and/or supervision, negligent infliction of emotional distress, and civil conspiracy. The defendants filed a motion to dismiss the plaintiffs’ complaint pursuant to Mass. R. Civ. P. 12(b)(6).

The plaintiff opposed the defendants’ motion and moved for permission to amend her complaint to assert a claim for retaliation under the federal Family and Medical Leave Act (FMLA). The trial court judge dismissed the plaintiff’s complaint without ruling on her motion to amend. The plaintiff appealed.

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In order to receive Massachusetts workers’ compensation benefits for a work-related injury or death, the person filing the claim must be able to show that the accident that led to the injury or death occurred during the course of the worker’s job duties. Usually, this is an easily resolved issue, but sometimes the particular circumstances of an accident can result in substantial disagreement between the parties as to whether the employee was truly acting in the course of his or her employment.

If the worker’s compensation insurance company denies the claim, the matter will likely proceed to a determination by an administrative law judge; this decision may be further appealed, should either side wish to seek review. If you or someone you know is considering filing a claim for a workplace injury or death, now is the time to speak with a Cape Cod workers’ compensation attorney.

Facts of the Case

In a recent case appealed from the Industrial Accident Reviewing Board, the widow of a man who was killed in an automobile accident sought workers’ compensation benefits on the basis that the decedent (who was the principal of a family-owned business) was killed during the course of business. The defendant insurance company denied the claim. A three-day hearing was held before an administrative law judge. The judge denied the widow’s claim, concluding that the trip during which the decedent was killed was not an undertaking that was in the course of the insured company’s business. The Department of Industrial Accidents’ reviewing board summarily adopted the ALJ’s decision. The widow sought further review.

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