Workers’ Compensation Benefits Denied in MVA with Depression, Traumatic Brain Injury

Attorney John Dealy obtained a denial of benefits on behalf of a public employer in connection with injuries claimed by a supervisory employee who was struck by a motor vehicle.  The employee initially sought workers’ compensation benefits for treatment of bilateral leg injuries sustained in the accident.  He subsequently added a claim for psychological injuries.  When his temporary, partial disability benefits (M.G.L. c. 152, § 35) expired, he pursued a claim for permanent, total disability benefits based upon a combination of psychological and physical injuries.  The insurer’s potential exposure was more than $115,000 in retroactive benefits plus approximately $30,000 annually for the rest of the employee’s life.

In a 2007 hearing decision, the employee was awarded temporary, partial disability benefits plus payment of medical and psychological treatment.  At the time, the administrative judge determined that the employee had not sustained any disability for his alleged psychological injuries.  The employee appealed the decision to the Claims Review Board, seeking temporary, total disability benefits.  The hearing decision was upheld.  The employee appealed the adverse ruling to the Appeals Court, which affirmed the Claims Review Board’s decision.

Shortly before the expiration of the employee’s temporary, total benefits under the 2007 hearing decision, he first began psychological treatment and asserted a claim for permanent, total disability benefits (M.G.L. c. 152, §34A).  The asserted grounds for this claim were that the employee’s psychiatric condition, when paired with his impaired physical condition, rendered him permanently and totally disabled from gainful employment.

Defense counsel disputed the causal relationship of the employee’s alleged ongoing physical injuries as well as the nature, extent and causal relationship of his alleged claim of psychological injuries.  The employee’s claim was denied at the conference level and he appealed to a hearing.

In 2012, an impartial physician (psychiatrist) examined the employee. He evaluated the employee’s complaints of pain and supported the employee’s position that he had suffered psychological injuries (including depression) as a direct result of the subject accident. Remarkably, the impartial physician also diagnosed the employee with a traumatic brain injury occurring in 1997 in a prior motor vehicle accident.  He further opined that this condition had worsened as a result of the work-related accident.

At the hearing, the employee amended his claim to include temporary, total disability benefits (M.G.L. c. 152, § 34) in addition to permanent, total disability benefits (M.G.L. c. 152, § 34A)  The employee sought benefits from 2007 to date and continuing.  Attorney Dealy argued that the employee was unable to sustain his burden of total and/or permanent disability causally related to the subject accident.  The employee’s credibility was successfully challenged on cross-examination.  Defense counsel also challenged the causal relationship of the employee’s ongoing physical injuries and pain, which were arguably related to vascular problems rather than the blunt traumatic injuries sustained when his legs were struck by a motor vehicle.  Finally Attorney Dealy used cross-examination testimony from the impartial physician’s deposition to argue that his findings were in conflict with the medical history provided, based upon discredited reports by the employee, and were outside the impartial physician’s medical training and expertise.

In his 14-page decision, the Administrative Judge held that the employee failed to demonstrate by credible testimony and medical evidence that he is totally disabled as a result of physical and/or psychological injuries causally related to his accident at work.  Accordingly, the Administrative Judge denied the employee’s claim in its entirety.

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