When a worker is hurt on the job, there are several types of benefits to which he or she may be entitled under Massachusetts workers’ compensation laws. These typically include medical expenses, temporary total or temporary partial disability payments, and permanent total or permanent partial disability benefits.
Unlike tort cases arising from accidents caused by negligence outside the workplace (a car accident, for instance), a worker is not “made whole,” economically speaking, in workers’ compensation cases. In other words, a worker does not receive total replacement of his or her lost wages, only a percentage thereof.
A recent case addresses the calculation of some of these benefits.
Facts of the Case
In a case recently decided by the Massachusetts Appeals Court, the plaintiff was a woman who allegedly suffered a work-related injury (in the form of bilateral carpel tunnel syndrome) in 2011. An administrative law judge issued an order requiring the defendant insurer to pay the plaintiff $235.43 per week in partial disability benefits, but the judge’s order did not include a computation of the plaintiff’s earning capacity under Massachusetts General Laws ch. 152 § 35D.
After an appeal and a remand, the administrative law judge reduced the plaintiff’s benefits to $121.91 from the time of her injury until December 31, 2014. After an increase in the minimum wage went into effect on January 1, 2015, the defendant owed the plaintiff $97.91 per week, according to the judge.
The reviewing board affirmed the administrative law judge’s decision, and the plaintiff appealed.
Decision of the Commonwealth of Massachusetts Appeals Court
The appellate court affirmed, first noting that it could only reverse the reviewing board’s decision if it was wholly lacking in evidentiary support or tainted by errors of law. The court then recited the formula for determining partial incapacitation benefits: the worker is to receive “weekly compensation equal to 60% of the difference between his or her average weekly wage before the injury and the weekly wage he or she is capable of earning after the injury.”
The court also noted that an injured worker seeking partial disability benefits may not receive more than 75% of the amount to which he or she would have been entitled had he or she been totally incapacitated. Given that the plaintiff’s average weekly wage was stipulated by the parties to be $523.19 prior to her injury, the highest total disability benefits that she could collect was $313.91; thus her partial disability benefit was capped at $235.43. However, this amount did not take into consideration the plaintiff’s post-injury earning capacity.
Given certain testimony by a medical expert that the plaintiff could perform limited work and a vocational rehabilitation consultant’s opinion that the plaintiff could earn $8 to $12.60 per hour after her injury, the appellate court found that there was ample support for the earning capacity calculation of the administrative law judge on remand.
To Speak with a Seasoned Massachusetts Workers’ Compensation Lawyer
The benefits available in a workers’ compensation case are highly structured, but this does not mean that there are not points of negotiation – or that an employer or its insurance company will automatically “do the right thing.” Many cases are quite contentious, so it is important that the injured worker receive dependable legal advice about his or her rights. The experienced Cape Cod work injury team at the Law Offices of John C. Manoog, III, can help. For a free consultation, call (888) 262-6664. We can come to your home or hospital if necessary, and nos falamos Portugues.
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