ABRAMS, J. The applicant, Evelyn J. Weitzel, brought an action before the Supreme Court seeking an agreement with the defendant, Travelers Insurance Companies (Travelers), for the payment of workers` compensation. In the complaint, it was alleged that this was a violation of the unlawful benefits in violation of G. L.c 152, §8 (1992, para. A Supreme Court judge dismissed the complaint for lack of factual jurisdiction. Article 1(7A) is a positive defence which the insurer must present during the oral proceedings in order to maintain the worker`s high standard of proof that the impairment at work was a `major cause` of the resulting disability. The insurer must provide certain medical evidence that the worker`s alleged injury is “combined” with a previous illness resulting from an injury or illness that caused the resulting disability. MacDonald`s Case, 73 Mass. App. Ct. 657 (2009). The dorsal load is the most common, which is superimposed on a pre-existing state of degenerative intervertebral disc disease, but the section applies wherever the predictive element can be shown.
The burden on the presentation of medical evidence is not high, but it must be sufficient to point out that the worker`s alleged disability is accompanied by a combination of causes. Non-medical factors such as age, which cannot be attributed to an “injury or illness”, are not considered medical history. If you are dealing directly with the workers` compensation insurer yourself and the insurer proposes an agreement in accordance with Section 19, you should have the agreement verified by an experienced attorney in Massachusetts to ensure that all aspects of your rights are considered and that your rights are protected. The DIA has a form called a Section 19 agreement, which must be completed and signed by the employee, his or her lawyer, if applicable, and the insurer`s lawyer before being submitted to the DIA. The agreement would then be submitted to the DIA for approval. Typically, an administrative judge would review the agreement and, if acceptable, approve it. Once approved, the parties would be bound by this agreement. For example, if the agreement provides that the insurer temporarily pays the injured worker all disability benefits for a given period, the insurer, once approved by the DIA, must pay the disability benefits for which it has accepted payment. If it is a licensed agreement and an insurance company that will not fulfill its obligations under this agreement, it is necessary to submit to the upper section of the court, for Suffolk County or Suffolk County, a certified copy of your employees` compensation file, in conjunction with a “claimant`s complaint”. Failure by the insurance company to comply with an enforceable title of a higher court is subject to possible action in defiance of the party.
When there is a dispute over a worker`s right to compensation, the dispute is sometimes settled by the parties who reached an agreement instead of a judge making a decision on the right. For example, if the insurer refuses to pay the injured worker the disability benefits it claims or refuses to pay for medical treatment, the injured worker (or his or her lawyer) would generally file a claim for benefits with the Massachusetts Department of Industrial Accidents. While the appeal is pending, the parties can reach an agreement that would resolve the dispute that has emerged. Once the agreement is concluded, the parties would reduce the agreement to the letter to recall the agreement. The written agreement would then be submitted to the DIA for review by an administrative judge. . . .