Highest Court in Massachusetts Rules That Workers’ Comp Lien Does Not Attach To Pain And Suffering

In Massachusetts, a worker, injured in a work accident caused by a third party, can recover benefits from their employer’s workers’ compensation insurance company as well as pursue compensation by way of a third-party personal injury lawsuit. The Massachusetts Workers’ Compensation Act allows for a statutory workers’ compensation lien on any third-party recovery. A recent ruling by the Massachusetts Supreme Judicial Court explained, however, that a workers’ compensation lien does not extend to any damages allocated for the injured worker’s pain and suffering recovered in the third party personal injury claim. DiCarlo vs. Suffolk Construction. Co, Inc., 473 Mass. 624 (2016). This ruling provides the Courts more leeway when deciding to approve third party settlements that arose from a work-related accident.

Massachusetts Workers’ Compensation Basics

Employees, who are injured while in the course of their employment and, otherwise, qualify, are entitled to receive workers’ compensation benefits in Massachusetts. An injured worker, who receives these benefits, may not sue their employer for injuries or damages that arise out of the work-related accident. (See Massachusetts General Laws, Chapter 152 § 24). These injured workers are entitled to receive workers’ compensation benefits regardless of who caused the work accident. This means that the injured worker does not have to prove anyone was negligent to receive these benefits and can even receive the benefits if the injured worker caused the accident. This is why the workers’ compensation benefits are sometimes referred to as “no fault” benefits. Because it doesn’t matter whose fault the accident was. The workers’ compensation benefits are limited, however. Disability benefits are available to replace a percentage of the lost wages, medical benefits will cover the cost of medical treatment, and some other benefits are available, such as benefits for scarring and loss of function. Workers’ compensation in Massachusetts does not offer any payments to the injured worker for any pain and suffering. 

Third Party Personal Injury Lawsuits in Massachusetts Stemming from a Work-Related Accident

An injured worker may file a personal injury claim or lawsuit against third parties for the injuries and damages they sustain in the work related accident. This third party claim or lawsuit is in addition to the workers’ compensation claim for benefits. In the third-party personal injury claim or lawsuit, however, the injured worker must prove the third party was negligent. In a nut shell, it must be established that the third party breached a duty owed to the injured employee and that breach caused the employee’s injuries and damages.

The third party personal injury claim or lawsuit offers injured employees compensation, if they are successful in the claim or case, that are not offered or available from workers’ compensation. One specific element of damages that may be recovered in a third party case is pain and suffering.

Workers’ Compensation Insurer’s Lien on a Third-Party Claim and Pain & Suffering

The workers’ compensation insurer is entitled to a statutory lien on the recovery from a third party personal injury claim or lawsuit that stems from the work-related accident. (See M.G.L. c. 152 § 15). The issue presented in the DiCarlo case was whether the workers’ compensation lien attaches to damages paid by a negligent third-party for the employee’s pain and suffering. The SJC held that the lien does not attach to pain and suffering damages.

In the DiCarlo case two employees were injured in construction accidents and received workers’ compensation benefits. The injured employees filed personal injury negligence actions against third parties, which ended in settlements.  As part of the settlements a certain amount of money was allocated to the employees’ pain and suffering. The workers’ compensation insurers asserted that their lien attached to the allocation of money for the employees’ pain and suffering. The employees, in the other hand, argued that the workers’ compensation lien did not attach to the pain and suffering damages. The SJC agreed with the employees and, in support of their ruling, explained that the workers’ compensation insurer did not pay the injured employees benefits for their pain and suffering. Therefore, the insurer cannot seek reimbursement from the pain and suffering damages paid by the third parties.  

This SJC decision will make it easier to settle third-party personal injury claims with a workers’ compensation lien.  The injured worker can allocate a reasonable amount of the third party settlement to pain and suffering, which is out of the workers’ compensation lien’s reach. The key word is “reasonable”. All third party settlements must be approved by a Judge. Therefore, a Judge most likely will not approve a settlement that disproportionally and unreasonably allocates money from the third party settlement to pain and suffering. A Judge may find that strategy prevents the workers’ compensation insurer from receiving fair reimbursement for the benefits they paid the injured worker. In the end, this SJC ruling will provide injured workers greater financial compensation for their injuries and losses suffered in the accident.

Get Legal Help

If you have been hurt in an accident on the job and the accident was caused by a third party, you may be entitled to workers compensation and have a third party personal injury claim against the third party, who caused the accident. A very important decision you can make is to seek legal advice and guidance from an experienced injury attorney.

Mahaney & Pappas, LLP has represented numerous employees hurt on the job get the compensation they deserve from both their employer’s workers compensation insurer and from negligent third parties, who were legally responsible for causing the employees’ injuries. We offer free, no-obligation initial meetings and case evaluations. All you have to do is call (508) 879-3500 or contact us online today. Call today to see how we can help you. 

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