Causation in Massachusetts Workers’ Compensation Cases

In Massachusetts, a worker must be able to show that an injury or illness is work-related in order to get workers’ compensation coverage for it. The rules can get complicated depending upon the type of injury or illness and the existence of pre-existing conditions.

Some of the kinds of illnesses and injuries that may be covered if they are caused by work: illness from toxic substances at work, a work-induced heart attack, mental health problems caused by a job, scarring or disfigurement, hernias or back problems caused by work, broken bones and more.

In a recent case, Orbelina Vides v. Charles Hotel, reviewed by the Massachusetts workers’ compensation reviewing board, an assistant to a cook was injured at work in her “right dominant upper extremity” and had to stay away from work for six weeks. Upon returning to her workplace, her pain increased. Accordingly, she left again and underwent a surgery that included her right forearm, her radial ulnar nerve and radial tunnel. She again returned to work four months after that.

Her employer’s insurer paid her weekly benefits for her work-related incapacity. However, several months later, it filed to discontinue or modify her compensation. The judge denied this complaint and the insurer appealed.

The employee was examined by a doctor who wrote a medical report and addendum. The doctor was deposed. The employee asked to submit additional medical evidence, but was denied, and so only the doctor’s medical opinions were used to consider how bad the disability was and whether it was caused by the workplace accident.

The judge credited the employee’s testimony with a finding that the surgery had helped a bit, but had not taken away all the pain. The employee had testified about constant pain that went from her neck to her shoulder, arm and hand, pain that made it hard to use that area. She took Ibuprofen, but the relief was only temporary.

The judge also adopted the doctor’s opinions, which included the diagnosis of a torn right shoulder rotator cuff, radicular neck pain and status post-right radial tunnel syndrome with surgical decompression. The judge found that the employee’s injury kept her from doing anything more than light work, and also prevented her from lifting more than 5 lbs. The doctor didn’t attribute this restriction to the employee’s neck injury. The judge didn’t explain whether she found that this condition was caused by work.

The employee had testified about how the surgery had helped only a little bit. The employee’s testimony hadn’t included an explanation about the source of her pain.

The insurer agreed it was liable, but did not stipulate as to what kind of injury the employee had and why. In fact, the insurer denied a causal relationship and pointed to the doctor’s opinion in an addendum that the employee’s neck was not work related.

The Massachusetts workers’ compensation reviewing board agreed with the insurer that the record did not support a finding that the employee’s workplace accident caused her neck condition. A judge is supposed to assess an injured employee’s working condition without looking at the effect of non-work related medical problems. The judge in this case had not done that.

If you are injured at work, an experienced Massachusetts workers’ compensation attorney may be able to help you obtain benefits and advise you on next steps. Contact us by calling 800-367-0871 or using our online contact form.