Articles Posted in Health Insurance and Workers’ Compensation

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joshua-mancini-6fegAz1Us5U-unsplash-scaledIn the construction industry, there is a general rule of thumb often referred to as the “6-foot rule.”  The “6-foot rule” typically is applied to major commercial construction projects, as well as smaller residential construction projects, amongst others.  Essentially, the 6-foot rule requires employers to implement the use of fall protection when construction workers are working at heights of 6 feet or greater above a lower level.

At the Carney, Rezendes & Crowley, LLC, our attorneys have fought hard and successfully represented injured construction workers who were injured due to a “6-foot rule” safety violation. Recently, Attorneys Jeremy M. Carroll and Brendan G. Carney obtained a jury verdict in the amount of $925,000 for an injured construction worker who fell 10 feet because there was no fall protection.

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On October 29, 2020, The Massachusetts Supreme Judicial Court issued its ruling in Mark Mendes’s Case, No. SJC-12857, which held that the Massachusetts Department of Industrial Accidents has subject matter jurisdiction over a claim involving an interstate truck driver based on his employment having “sufficient significant contacts” with Massachusetts.  This opinion expands Massachusetts’ jurisdiction over workers’ compensation claims, where in the past they were limited to circumstances where:

  1. The employee was employed by a Massachusetts employer; or
  2. The employee was injured while working in Massachusetts; or
  3. The employment contract was executed in Massachusetts.

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No. Typically, you do not pay a personal injury or a workers’ compensation attorney out-of-pocket.  At the Carney, Rezendes & Crowley, LLC, we focus on personal injury and workers’ compensation cases which operate on what is called a “contingency” fee.   A “contingency fee” means that we only get paid if we get you compensation, which typically occurs through either a negotiated settlement, mediation, arbitration, or a jury trial verdict.

Why Not?

The reason for a “contingency fee” is to be able to provide legal representation to injured workers and injured people from all levels of income.  If personal injury or workers’ compensation attorneys required clients to pay attorney fees out-of-pocket, only wealthy people would be able to afford an attorney when they are hurt. Injured workers and people from all income levels deserve an attorney to fight for them and to represent them for injuries that never should have occurred. Here at the Carney, Rezendes & Crowley, LLC, we take pride in fighting for injured workers and people who are injured needlessly due to safety violations which occur in construction sites, motor vehicle collisions, and many other types of dangerous situations.

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Injured by a Forklift?

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Forklift, or Powered Industrial Truck (“P.I.T.”), injuries are very common in the construction industry for both drivers and nearby workers.  According to the Occupational Safety and Health Administration (OSHA), an estimated 85 deaths result each year as a result of forklift operation accidents, as well as almost 35,000 serious injuries and almost 62,000 non-serious injuries per year.  In the U.S., 1 in every 6 workplace deaths occur in forklift related incidents.

With roughly 856,000 total forklifts in the United States, this means that approximately 1 in 9 forklifts will be involved in an accident that results in injury or death.  Further, the Industrial Truck Association estimates the average use for the life of a forklift or P.I.T. is approximately 8 years.  Taking this factor into consideration, a fair projection calculates that almost 90% of forklifts will be involved in an incident that results in a worker getting injured over the course of the lifetime of the forklift.  At the Carney, Rezendes & Crowley, LLC, we have skilled and dedicated attorneys who are experienced representing people with personal injury and workers’ compensation claims resulting from forklift accidents.

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Do’s:

  • Always report your Injury. This sounds basic but it does not always happen and can create big problems down the road.  Report your injury to your foreman, steward, business agent, general contractor, supervisor or H.R. professional immediately, regardless of whether or not you think it is only a minor injury and you can continue working.   Often times injured workers do not report their injuries immediately, because they think that it is not a serious injury and they should “be fine by tomorrow.”  If your injury turns out to be more serious than initially thought, the failure to immediately report is likely to lead to the worker’s compensation insurer denying the claim.
  • Take photographs of the dangerous condition or defective equipment that caused your injury. Use your cellphone to take photographs that can later help prove you were injured on the job and may also be evidence for a third-party negligence claim.  It is important to document that dangerous condition that caused the injury.
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While the overall intention of Governor Baker’s opioid bill appears to be positive for those in Massachusetts dealing with chronic pain and opioid dependency, it contains a section that would be harmful to injured workers who rely on Massachusetts’ workers’ compensation insurance to pay for their prescription medication.  Section 39 of the Governor’s opioid bill would establish drug formularies in all workers’ compensation cases (not just those involving the prescription and use of opioids) and for all medications.  Section 39 of House Bill No. H-4033 states:

SECTION 39. Chapter 152 of the General Laws is hereby amended by inserting after the following section:

             Section 13 ½. The department shall establish a formulary of clinically appropriate medications, including opioids and related medications, and shall promulgate regulations for the administration of this formulary.  In establishing the formulary, the department shall consult with the health care services board and the drug formulary commission established in section 13 of chapter 17 of the General Laws.  The formulary shall be based on well-documented, evidence-based methodology, and the department shall include as part of the formulary a complete list of medications that are approved for payment under this chapter, and any specific payment, prescribing, or dispensing controls associated with the drugs on the list.  The department shall review and update, if necessary, the formulary at least once every 2 years.

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          Massachusetts’ workers’ compensation insurance pays for any medical treatment, tests, procedures and prescription medication that is “reasonable, necessary” and “causally related” to your work injury.  The workers’ compensation insurer will not automatically pay for these medical benefits.  Your medical provider MUST follow certain guidelines in order for the workers’ compensation insurer to pay for your medical treatment or prescriptions.  Here is the general process for your medical provider to follow in order to get your medical treatment and prescription medication approved by workers’ compensation: Continue reading

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In this Massachusetts’ workers’ compensation claim, an injured union sheet metal worker represented by Carney, Rezendes & Crowley, LLC was awarded Section 34A permanent and total disability benefits.  The injured worker, represented by Attorney Brendan G. Carney, initially injured his left knee at work in 1980.  He had left knee surgery and returned to work shortly thereafter.  Then in 1998, while working on a pitched roof, the worker felt a sharp pain in his left knee.  He underwent arthroscopic surgery, and returned to work once again after a few months of disability as he recovered from this second left knee surgery.  He continued to work as a sheet metal roofer, and then in 2008 his left knee pain returned.  He worked through pain, aided by injections, for four more years when his doctor told him he needed a total knee replacement.  Because by this point he had worked enough years to qualify for a retirement pension through his union, he retired from work because of his left knee condition.   Although his left knee symptoms were clearly all related to his history of work injuries, the worker was not aware that he was entitled to workers’ compensation benefits.  He consulted with another attorney who was not sure whether there was a viable workers’ compensation claim.  That prior attorney contacted our firm for guidance. After a thorough investigation of the injured workers’ medical and employment history, Carney, Rezendes & Crowley, LLC agreed to pursue the case.  A claim for Section 34 temporary total disability benefits and payment for medical treatment, and then later a claim for Section 34A permanent and total disability benefits were then pursued by our firm. Continue reading

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Unfortunately for injured workers in Massachusetts, the short answer to this question is “yes”.  Although Massachusetts General Laws Chapter 152, Section 75B(2) provides a legal remedy to injured workers who are fired in retaliation for filing a workers’ compensation claim, the law does not provide any protection for injured workers’ to protect their ongoing health insurance paid for by their employer.  The exception to this is that most union member’s are subject to collective bargaining agreement provisions (negotiated by their respective labor unions) that provide ongoing health insurance coverage for injured workers for a certain period of time during a period of disability from work.  However, most non-union employees have no protection at all.  Although the general answer to the question posed by this blog is “Yes”, there are some federal laws that may protect an injured workers’ ongoing entitlement to health insurance coverage. Continue reading

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