In King v. APA Transport Inc., a Massachusetts employee received § 34A workers’ compensation benefits following an on-the-job back injury he sustained in a 1999 industrial accident. Several years later, the worker sought §§ 13 and 30 benefits for medical expenses related to his back harm. As part of this request, the worker asked his employer to reimburse him for a variety of co-payments made to his psychiatrist beginning in 2003 and a second physician beginning in 2005. The employee also sought compensation related to his resulting pharmaceutical prescriptions.
After the worker’s employer denied his medical payments request, an administrative judge ordered the employer to reimburse the employee’s ongoing medical expenses beginning on the date of a December 2011 workers’ compensation benefits conference. In response, the employer filed an appeal. The worker was then examined by a psychiatrist pursuant to § 11A(2). The neutral psychiatrist’s testimony was the only medical opinion provided at a subsequent hearing on the matter.
Following the hearing, the administrative judge adopted the impartial psychiatrist’s opinion that the employee’s back injury caused him to develop a major depressive disorder. The psychiatrist also stated the worker’s malaise was in partial remission due to the prescription medications his personal psychiatrist provided to him. After stating she credited the employee’s testimony regarding the copayments made by the worker, the judge ordered the employer to pay nearly $6,000 in medical benefits to the injured man. The administrative judge also awarded the worker ongoing medical benefits.
On appeal to the Department of Industrial Accidents Reviewing Board, the employer argued the judge committed error by awarding the worker medical copay reimbursement under § 30 because a 2003 decision by the Board prohibited such an award. The Board disagreed and stated the employer distorted the holding in the prior case. According to the Board, the case at issue did not prohibit an employer from reimbursing a worker’s healthcare copay. Instead, the Board said it found that the insurer in the 2003 case paid only a fraction of its statutory obligation.
Next, the Board stated the employer’s argument would yield a result that was contrary to the intent of the Massachusetts Legislature. The Board said the workers’ compensation law demonstrates that employers or their insurers, not hurt workers and third parties, are responsible for any medical treatment that results from a workplace injury. Additionally, the Board distinguished the worker’s case by stating the administrative judge ordered the employer to pay all of the injured employee’s medical costs beginning on the date of his harm rather than only those copays paid by the worker.
The Board then dismissed the employer’s claim that the judge’s decision should be overturned because she committed error when she admitted certain evidence related to the worker’s medical expenses into the record. The Board said the error was harmless because the administrative judge did not rely on the documents at issue in reaching her conclusion. Additionally, the Board refused to consider the employer’s assertion that the employee’s testimony on which the judge relied was speculative since the employer failed to object to the evidence at the administrative hearing.
Finally, the Department of Industrial Accidents Reviewing Board affirmed the administrative judge’s decision awarding the hurt employee §§ 13 and 30 workers’ compensation benefits and ordered the employer to pay the employee’s legal fees related to the appeal.
If you were hurt at work in Massachusetts, you are advised to discuss your right to recover financial compensation with the experienced workers’ compensation lawyers at Kantrovitz & Associates, P.C. Our seasoned attorneys are available to help you recover the benefits you may be entitled to following a work-related injury. To speak with a veteran Massachusetts workers’ compensation advocate about your case, give Kantrovitz & Associates, P.C. a call at 800-367-0871 or contact us through our website.
King v. APA Transport Inc., Department of Industrial Accidents Reviewing Board Decision No. 030256-99 (June 18, 2015)