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Boston Workers’ Comp and Pre-Existing Conditions

In a typical workers’ compensation case in Boston, claimant is working and gets injured.  Once claimant is injured, he or she should immediately inform a supervisor of the workplace accident.  This is essential because if the supervisor doesn’t report the accident there will be no record of claimant being injured. When claimant applies for workers’ compensation benefits, employer’s workers’ compensation insurance company may deny the claim for not being put on notice.

Boston work accident lawyerPursuant to Chapter 152 of the Massachusetts General Laws, workers’ compensation insurance company has between 15 and 30 days to either pay benefits for lost wages and medical bills or to deny the claim.  If a claim is denied, claimant must file an appeal with the Massachusetts Department of Industrial Accidents (DIA).  Some cases are more complicated than others as they involve an aggravation of a pre-existing condition as our Boston workers’ compensation attorneys can explain.  One recent case from the Wyoming Supreme Court deals with this issue.

Boyce v. State ex rel. Department of Workforce Services

In Boyce, claimant was working for employer as a “frac hand.”  A frac hand is an employee who is responsible for driving equipment to natural gas wells and setting up the equipment.  Once the equipment was no longer needed, claimant would take the equipment down and haul it away from the well site.

On one job, he was driving some every dangerous equipment to a well when he stopped at a truck stop.  He realized the giant hazardous materials placard he was required to have had fallen off his truck.  He told his supervisor about it and they both doubled back and look for the placard. Once they found it, they attempted to lift it back onto the back of his truck.  It was over eight feet across and weighed over 100 pounds. As they lifted the sign up, claimant moved in an awkward way and injured his groin.

Claimant finished the trip and two days later, he went to see his doctor. His doctor thought he had a hernia from lifting the placard and sent him to a surgeon for evaluation. Employer sent a claim to  workers’ compensation employer saying that employee was injured while lifting the placard.  The report said it was  groin strain.

He was diagnosed with a hernia and scheduled for surgery.  He could not have the surgery right away because he was dealing with back pain.  He did not tell his doctor about the back pain and was sent to surgery and then cleared to return to work. He told insurer he was having back pain and it was ultimately determined he had a disc injury to his spine. He eventually needed spinal surgery and his employer’s insurance company denied his claim.  The claim was denied because they claimed he had not demonstrated the back injury was related to his on the job accident an not a pre-existing condition.

He eventually had a hearing before the workers’ compensation commission but his benefits were denied.  Upon appeal to a civil court, workers’ compensation benefits were again denied, and the state supreme  court ultimately agreed.

There was a great deal of medical testimony on both sides during the hearings and trial, but the reality of the situation is that it is very difficult to overcome the fact that claimant had not reported the injury to his employer or even his doctor when he first noticed the pain.  The need to give prompt notice of an injury to both employers and doctors is even more important in cases where we are dealing with injuries that are considered degenerative conditions and or not often caused by work. This can include some of the following:

  • Degenerative Disc Conditions
  • Joint Disease
  • Hip pain
  • Osteoarthritis
  • Osteoporosis
  • Hearing Loss
  • Vision Loss

In Massachusetts, just because a worker has a pre-existing condition doesn’t mean workers’ compensation is not available.  The requirement is that worker suffered a workplace accident or work-related illness that aggravated the pre-existing condition.  The test used in Massachusetts  workers; compensation cases is whether the workplace accident or work-related illness was a major factor in the harm suffered.  If the on the job accident was a major factor in the harm suffered, than workers’ compensation benefits should be available.

This does not mean that the workplace accident be the sole factor, or even a predominant factor, but only that it be a major cause. For example, if worker has degenerative joint disease in his hip and slips and falls at work, this could do significant damage to his hip causing to him need an artificial hip implant. If claimant did not have a pre-existing condition in his hip, he probably would have still been hurt, but would not need a total hip replacement. On the other hand, had the worker not been injured on the job, he also would not need a total hip replacement at this time.  He may eventually need one but that could be years away.  In this example, he had a pre-existing condition, and that condition was aggravated by his workplace accident.

This is only one example of a pre-existing contion in a Boston workers’ compensation case.  There are many others and they can involve a good deal of complex litigation. The best thing claimant can do is to speak with an experienced workers’ compensation attorney who has handled these matters in the past. Claimants should not worry about being able to afford an experienced attorney because the system was set up in such a way that there will be no legal fees unless successful.

If you are the victim of Massachusetts product liability, call the Law Offices of Jeffrey S. Glassman for a free and confidential appointment — 1-888-367-2900.

Additional Resources:

Boyce v. State ex rel. Department of Workforce Services, August 31, 2017, Wyoming Supreme Court

More Blog Entries:

HVAC Worker in Worcester Dies in Fall Accident, Feb. 13, 2017, Massachusetts Workers’ Compensation Lawyer Blog