Massachusetts Court Refuses to Disturb ALJ’s Denial of Workers’ Compensation Benefits Without Supporting Medical Evidence on Appeal – William J. Jackson’s Case

Those who are injured on the job have a legal right to seek workers’ compensation benefits to cover medical expenses and at least partially offset lost wages. If a particular work injury results in a permanent disability, a worker may also file a claim for incapacity benefits.

Of course, the benefits are not automatic, and the plaintiff must comply with all of the procedural requirements set forth under Massachusetts law. Even then, there is the possibility that he or she may be met with opposition from the employer or its insurance company, especially with regard to the issue of permanent disability.

Facts of the Case

In the recent (unreported) case of William J. Jackson’s Case, the claimant was a man who worked for an entity that managed apartment buildings. In 2010, he suffered a work-related injury when he was hit by a car while on the job. He was off work for a week and was later terminated for reasons unrelated to the work-related injury. After receiving unemployment benefits for a period, he filed a claim for weekly incapacity benefits, asserting that the injuries associated with the 2010 work accident prevented him from working.

The claimant was examined by an impartial medical examiner (IME), who supported, at least in part, the claimant’s allegations of disability resulting from the 2010 car accident. However, the administrative judge of the Department of Industrial Accidents (DIA) found the IME report submitted by the claimant to be less probative than a contrary report written by the main medical expert of the insurance company of the claimant’s employer.

Accordingly, the administrative law judge denied benefits to the claimant. The DIA affirmed the denial of benefits, and the claimant appealed.

Holding of the Court

The court affirmed the DIA and the administrative law judge’s denial of benefits to the worker. Although the claimant argued that the administrative law judge was obliged to accept the IME’s opinion, the court ruled against him “if for no other reason” than the fact that the claimant did not include the IME report or any other medical evidence in his documentation in support of his appeal. Without a basis for evaluating the merits of the claimant’s arguments, the court had no basis to disturb the opinion of the lower tribunal.

Talk to a Knowledgeable Cape Cod Work Injury Lawyer

Worker’s compensation claims are frequently met with considerable resistance, even when it is clear that an accident happened in the course and scope of employment. The employer’s insurance company may resist paying certain benefits, leaving the worker little choice but to retain legal representation in hopes of a fair settlement or judgment. If you need to talk to an experienced Cape Cod workers’ compensation lawyer about your work injury, call the Law Offices of John C. Manoog, III, at (508) 775-0088 for a free consultation in our Hyannis or Plymouth office.

Related Blog Posts:

Workers’ Compensation Case by Massachusetts Employee with Pre-Existing Condition Failed Due to Proof that Work-Related Injury Was Major Cause of Current Disability – Adrian Aleman’s Case Massachusetts Worker Was No Longer Entitled to Workers’ Compensation Benefits When Continuing Disability Was Caused by Obesity and Pre-Existing Condition – Robert Amaral’s Case