Medical Malpractice in Workers’ Compensation Claims

Massachusetts Disability Lawyers

The Massachusetts workers’ compensation attorneys at Kantrovitz & Associates have over 25 years of experience handling personal injury and disability claims. We understand how medical negligence can hinder the full recovery of workers’ compensation benefits, and are dedicated to pursuing all avenues of relief. Our Boston office has successfully handled job-related claims involving medical malpractice for injured workers in Massachusetts, Rhode Island, and New Hampshire.

Medical Malpractice

Since 1991, the Department of Industrial Accidents (DIA) has turned to impartial physicians in medical issue disputes. Because judges depend upon physicians to provide accurate medical evidence in workers’ compensation cases, the relationship between doctors and the insurers who hire them present several conflicts of interest. Although the DIA’s Impartial Physician Program has eliminated some incentives for inaccuracy in medical reporting, Massachusetts’ workers’ compensation laws provide few avenues for cases of medical negligence in this context. Yet medical malpractice can seriously affect the full recovery of benefits.

Workers’ Compensation

The Massachusetts Workers’ Compensation Act provides a no-fault insurance system for employees injured on the job. Injured workers can be awarded benefits through their employer’s workers’ compensation insurance regardless of negligence. This protects employers from being sued for personal injury. Although workers will receive compensation, even if they were careless, they also waive certain rights to recover much larger awards when the employer is negligent. However, employees are still allowed to bring “third-party claims” against negligent parties other than the employer who cause on-the-job injuries.

Medical Negligence Impacting Claims

Physicians, hospitals, therapists, nurses, and other health care providers can be held liable for malpractice when their professional negligence directly causes injury or death to the patient. Medical negligence means the violation of a legal duty or failure to meet the required standard expected of professionals in the same field. The impact on a workers’ compensation claim may involve:

• Preferred provider agreements
• Failure to provide requested care
• Failure to meet level of care expected of medical specialty
• Lower level of care caused “damages”
  • Requires financial or economic loss
• Lack of medical care injures employee
  • Can result in worsened condition or wrongful death

It is important to note that a health care provider’s failure to return patients to their pre-injury condition does not constitute medical malpractice. Fibromyalgia, for example, may be caused by the employee’s already poor physical condition, not a standard surgical procedure. Inferior medical service, on the other hand, merits the pursuit of both a medical malpractice and workers’ compensation claim. Attorneys with experience in both areas can represent patients in both.

Utilization Review (UR)

In cases of medical malpractice, insurance adjusters and nurse case managers work with UR specialists to separate the medical costs for the work-related injury and the costs to correct medical mistakes. Workers’ compensation insurers will most likely be held liable for the added costs necessary to properly treat the injury. A simultaneous malpractice claim will usually delay settlement of the workers’ compensation claim, but allows the recovery of damages for pain and suffering and other benefits not awarded in a workers’ compensation case.

Helping You Pursue Maximum Compensation

If you suspect medical negligence in the treatment of your job-related injury, the Massachusetts workers’ compensation lawyers at Kantrovitz & Associates can help. We have the knowledge and experience necessary to help you maximize both your workers’ compensation benefits and personal injury damages. Our firm has recovered substantial verdicts and settlements for injured workers and personal injury victims in Boston, Essex, Middlesex, Norfolk, Suffolk, Plymouth, and Merrimack Counties, among others. Call 800-367-0871 for a free consultation or contact us online.