Articles Posted in WORK RELATED INJURY

Boston Massachusetts Personal Injury Attorney, Keith L. Miller, reviews a recent Supreme Judicial Court case involving an injured police officer:

A Massachusetts police officer who suffered serious personal injuries, while responding to a motor vehicle/pedestrian accident, cannot recover from the hospital, which treated and released the pedestrian just prior to the accident, says the Massachusetts Supreme Judicial Court.

Thumbnail image for eps_mg-182.jpgIn November, 2004, the Brockton, Massachusetts police officer, was responding to a car accident involving a pedestrian, While driving to the accident scene, the officer’s police cruiser was struck by another vehicle resulting in serious and permanent injuries to the officer. He was responding to an accident in which an individual just released from Brockton Hospital had been struck and killed by a motor vehicle.

The patient had undergone a colonoscopy at the hospital earlier in the day and had been given Demerol and Versed, both narcotic sedatives. The hospital had a written policy, which prevented patients who had been given narcotics from being discharged without an escort. This patient left the hospital with no escort.

The Plaintiff police officer had alleged that the hospital was negligent and had a duty of care to protect third parties from harm caused by its “impaired” patients. The officer claimed that the hospital had a special medical relationship with its patient prior to him leaving the premises, which created a duty to control the patient’s conduct in order to protect against harm the patient might cause to others, even after the patient had been discharged.

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Massachusettts Personal Injury Attorney, Keith L. Miller, reviews and analyzes a recent U.S. First Circuit Court of Appeals decision. This is the second part of a two part blogpost, involving the denial of an employee long term disability claim, where the insurer both reviewed and paid claims, allegedly giving rise to a conflict of interest. The First Part reviewed facts leading up the to the employee’s application for long term disability insurance, which the insurer rejected, and resulted in an action in Federal District Court.

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In June of 2002, the plaintiff employee in this case filed for long-term benefits. She would qualify as disabled under the long-term plan if, for two consecutive years, she was unable to perform the material and substantial duties of her occupation, and subsequently was unable to perform “the material and substantial duties of any occupation”. The same Liberty nurse who had denied her earlier claim, also reviewed this file, which contained medical support for a finding that the plaintiff’s symptoms had become worse. She had also completed an activities questionnaire in which she claimed to have severe restrictions on her ability to sit, stand, walk, drive, and concentrate.

liberty mutual 2.jpgIn her second review, the Liberty Mutual nurse discounted the IME report, suggested that the plaintiff’s condition was not as grave as the completed questionnaire implied, concluded that the plaintiff did not qualify for benefits and Liberty denied the claim. The plaintiff requested further review. Liberty responded by hiring a private investigator to observe the plaintiff’s activities. The investigator produced reports and photographs showing that the plaintiff was active.

With this information, Liberty then utilized a referral service furnishing physicians to evaluate the functional abilities of claimants. One of its physicians concluded that the plaintiff was capable of working full-time in her primarily sedentary position. On December 10, 2002, Liberty reaffirmed its earlier denial of benefits.

Fourteen months later, an administrative law judge ruled the plaintiff was entitled to social security disability benefits retroactive to her last day of actual work. The judge premised this decision on a subsidiary finding that the plaintiff was disabled within the meaning of the Social Security Act. Although the definition of disability under the Act differed from the definition of disability under the Liberty’s plan, the plaintiff forwarded the SSDI ruling to Liberty, along with a further report from her rheumatologist, seeking reconsideration of the denial.


Liberty refused to reverse its decision, which resulted in the district court action. The U.S. District Court granted summary judgement to Liberty, deciding that Liberty had not abused its discretion in denying the claim. On initial appeal, the Appeals Court affirmed, but then the United States Supreme Court made a ruling, which changed the substantive law in the area and resulted in a successful request for rehearing of this case.

IThumbnail image for supreme court.jpgn rehearing the case, the Court analyzed the Supreme Court’s decision in  Metropolitan Life Insurance Co. v. Glenn, 128 S. Ct. 2343 (2008). There, the Supreme Court had reviewed a denial of benefits by an administrator that passed judgment upon and paid claims under an ERISA-regulated plan.  It concluded that courts should recognize that a conflict exists whenever a plan administrator, whether an employer or an insurer, is in the position of both adjudicating claims and paying awarded benefits.

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This is the first of a two part Blogpost, where Massachusettts Personal Injury Attorney, Keith L. Miller, reviews and analyzes a recent First Circuit U.S. Court of Appeals decision. The case involves an employee disability claim and issues pertaining to a perceived conflict of interest.

liberty mutual.jpgIn this case, the U.S. First Circuit Court of Appeals remanded a case to the District Court, where an employee challenged the denial of her request for long-term disability benefits. The Plaintiff alleged that the employer’s insurer, who denied her benefits, both reviewed and decided on her eligibility and was responsible for the payments, which was a conflict of interest. She also alleged that a physician referral service the insurer utilized was biased, given it generated large revenues from its reviews, and usually recommended in favor of the employer.

The Court justified the remand, based on a recent decision of the United States Supreme Court in Metropolitan Life Insurance Co. v. Glenn, 128 S. Ct. 2343 (2008). The Supreme Court had previously reviewed a denial of benefits by an administrator that passed judgment upon and paid claims under an ERISA-regulated plan.  It concluded that courts should recognize that a conflict exists whenever a plan administrator, whether an employer or an insurer, is in the position of both adjudicating claims and paying awarded benefits.

fibromylagia.jpgIn this case, in 1996 a primary care physician had diagnosed the plaintiff employee as suffering from fibromyalgia, which is a disorder involving muscle and connective tissue pain. Patients note heightened and painful response to gentle touch, as well as debilitating fatigue, sleep disturbance, and joint stiffness. The plaintiff was a group leader employed by GenRad, Inc. In spite of the diagnosis, she continued to work. At the time she was covered under a short-term and a long-term disability insurance plan supplied by Defendant, Liberty Life Assurance Company (Liberty), who also administered both plans.

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Boston Personal Injury Lawyer, Keith L. Miller, analyzes a recent Appeals Court decision pertaining to double penalties under the Worken’s Compensation Act.

The case involves a store employee who suffered serious personal injuries after falling through a trap door in the floor of a floral shop, the Massachusetts Appeals Court has reversed a decision by the Department of Industrial Accidents reviewing board that awarded an employee double compensation (under Mass. G.L. c. 152, § 28), finding that the employee’s injury was due to the serious and wilful misconduct of the employer. The Appeals Court determined that the record did not support a finding that the employer’s conduct rose to the level of a wanton and reckless disregard for safety.

trap door.jpgThe employee was working at a floral shop on Valentines day in 1991 when she fell into a trap-door floor opening, which covered a set of stairs leading down to the cellar. She fell into the hole sustaining serious personal injuries. The floor door measured approximately eight feet by three feet, and qualified as a “floor opening”, which made it subject to the state and federal regulations, and certain mandatory safeguards.

The employer was not aware of the regulations, and instead relied on its own warning system of orange safety cones and chains to warn and protect the employees. However, the system was only used sporadically, and was not in place on the day of the accident. There was also some evidence that there may have been insufficient floor space in the area of the trap door due to the placement of a table for completed work orders. There was also evidence that because it was Valentine’s day, the work pace in the store was much heavier than normal.

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This is Part Two of a two part Blogpost where Boston Personal Injury Lawyer, Keith L. Miller, reviews and analyzes a recent First Circuit U.S. Court of Appeals ruling, in which an insurer sought a declaration that there was no coverage for an personal injuries as the result of an accident involving a contract worker who severed his arm in a wool picking machine. The worker had sued the Massachusetts recycling company where he had been working for a number of months. (Click here to view Part One)

PART TWO :  THE COURT ANALYZES DISTINCTION BETWEEN “LEASED WORKER” AND “TEMPORARY WORKER” IN POLICY TO DETERMINE COVERAGE

Having reviewed the underlying facts of the case, the Court went on to analyze the express language of the insurance policy, attempting to discern whether the lower court had correctly determined that the the worker’s contract was indefinite and therefore not temporary, which was its basis for ruling that there was no coverage for the accident.

wool baling machine.jpgIn the policy a leased worker was defined as a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm, to perform duties related to the conduct of your business. A temporary worker was defined as a person who is furnished to you to substitute for a permanent “employee” on leave or to meet seasonal or short-term workload conditions.

The question then for the Court of Appeals was whether Torres was a “leased worker,” and thus excluded from coverage; or a “temporary worker,” thus obligating Scottsdale to provide a defense and coverage in Torres’s lawsuit. The district court had determined that Torres was not a temporary worker on the basis that the term “short term” worker, though not defined in the policy, suggested a brief and relatively finite period of time.

Based on deposition testimony of CTC’s president that Torres was to stay at CTC “for as long as he was needed”, and a Venturi manager’s testimony that Torres was assigned to CTC “indefinitely,” the lower court determined  that “indefinite” and “short-term” were mutually exclusive, that Torres’ stay with CTC was indefinite and that he was therefore not a “temporary worker”. Therefore his claim was not covered under the policy.

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In this two part Blogpost, Boston Accident Lawyer, Keith L. Miller, reviews and analyzes a First Circuit U.S. Court of Appeals decision, which considers insurance coverage issues for an accident involving a man whose arm was severed in a wool picking machine, while engaged as a contract worker for a Western Massachusetts recycling company.

PART ONE :  PERSONAL INJURIES FROM CONTRACT WORKER’S SEVERED ARM MAY NOT BE COVERED BY INSURANCE

On August 23, 2004, Raul Torres suffered serious personal injuries when his arm was severed in a wool picking machine while working at Carrabassett Trading Company  “CTC”) in North Oxford, Massachusetts. CTC is a recycling company, which collects and recycles waste fiber from textile mills, bales up the material and sells them to other manufacturers. 

wool picking machine.jpgTorres was not an employee of CTC. Rather, his services were provided to CTC by his employer, Venturi Staffing Company, Inc (“Venturi”). Because CTC has an inconsistent demand for its products, it hires such contract workers to supplement its permanent staff of five. Torres filed suit against CTC in Massahusetts state court.

CTC’s insurer filed a federal court action seeking a declaration that there was no coverage for the injuries due to “employer” exceptions in the company’s liability policy. The Court reversed a district court ruling in favor of the insurer, and remanded the case for further proceedings.

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(This Boston Accident and Injury Lawyer Blogpost is the Last in a Three Part Analysis of a Recent U.S. Appeals Court Ruling involving defamation, public officials and the news media Click here to view Part One and Click Here to view Part Two)

PART THREE : THE COURT RULES ON THE DEFAMATORY BROADCAST

As stated previously, under Maine common law, a plaintiff alleging defamation must show a false and defamatory statement published without privilege to a third party resulting in harm to the plaintiff.

HAMSTEAK.jpgIn the lower court proceeding, the defendants had contended that the various statements made on the show and attributed to Levesque either were not defamatory or, because Levesque had stipulated that he was a public official, it could not be shown that they were made with actual malice. The district court held that the statements were protected on multiple grounds. It found the “hate crime” comments substantially true and mention of the “anti-ham response plan” protected as “rhetorical hyperbole”.

However, the lower court determined that the ham sandwich and the “ham is not a toy” comments were materially false, reasonably susceptible of a defamatory meaning, and highly offensive. Yet the court believed that Levesque had failed to demonstrate that the defendants had acted with constitutional malice when they made the defamatory comments.

The Court of Appeals agreed, finding that most, but not all of the statements attributed to the Plaintiff were largely true, although laced with “imaginative expression” or “rhetorical hyperbole”, which it concluded were protected speech.

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(This BlogPost written by Boston Personal Injury Attorney, Keith L. Miller, is the Second in a Three Part Analysis of a Recent U.S. Appeals Court Ruling involving defamation, public officials and the news media Click here to view Part One)

PART TWO – FOX & FRIENDS READS AND REACTS

On April 24, a line producer for “Fox & Friends” discovered the Plagman article. The Fox News Research Department read the Plagman article and conducted further research, and discovered additional information, including the original Lewiston Sun Journal story. The Plagman articles and other research materials were delivered to the show’s Doocy and Kilmeade. Doocy used Google News to conduct additional research, also found the Plagman article and Sun Journal stories, and decided to use the story as part of its show.

ham sandwich.jpgDuring the three-hour show, Doocy and Kilmeade repeatedly raised the April 11 incident, ridiculed Levesque, and blamed him for the handling of the incident. They reported as true several of the fabricated quotations that Plagman attributed to Levesque including the fact that the student had placed a ham sandwich on the table, the “ham is not a toy” statement and also attributed to Levesque a false statement comparing the incident to Mogadishu. Throughout the show, Doocy and Kilmeade repeated these falsified quotations.

After the April 11 incident, Levesque had received derogatory and threatening emails and phone calls from persons who learned about the incident and the student’s suspension. Of seventy-five emails submitted to the district court, sixty-nine were written after the “Fox & Friends” cablecast. As the result of these incidents, he elected to bring an action for defamation.

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(This Blogpost is the First in a Three Part Series by Boston Injury Lawyer, Keith L. Miller, who analyzes an interesting recent U.S. First Circuit Court of Appeals Ruling involving defamation, public officials and the news media. Click Here to view Part Two)

PART ONE – THE SCHOOL HATE CRIME INCIDENT MAKES LOCAL NEWS  

The U.S. District Court of Massachusetts has affirmed a lower Court’s summary judgment ruling that Fox News Network, LLC (“Fox”), and “Fox and Friends” television personalities, Steve Doocy and Brian Kilmeade, did not defame the Superintendent of the Lewiston, Maine public schools during a morning show, which ran in April, 2007.

FOX AND FRIENDS.jpgThe story involves an incident, which took place on April 11, 2007, when a student at the Lewiston Middle School placed a bag containing leftover ham on the cafeteria table where Somali Muslim students were sitting for lunch. The Somali students reported the incident, which resulted in an investigation and suspension of the offending students. The incident was classified as a “Hate Crime/Bias” in the school’s computer system, and a police report was filed characterizing the incident as “Crime: Harassment/Hate Bias.”

The Plaintiff, Leon Levesque, was the superintendent of the Lewiston School System. He was informed of the suspension and endorsed the decision. The following week, a reporter for the Lewiston Sun Journal, interviewed Levesque for an article she intended to write about the incident, which was published on April 19, 2007. The article included quotations from Levesque, describing the offending student’s conduct as “a hate incident”.
 

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This Blogpost by Boston Personal Injury and Accident Laywer, Keith L. Miller, anaylzes a battle between insurers over costs of construction accident.

Following a construction site accident where an insurer of a subcontractor refused to defend the general contractor, who then successfully filed a declaratory action to force the subcontractor’s insurer to share in the defense and settlement costs of the action, the Massachusetts Supreme Judicial Court has refused to permit the general’s insurer to recover the attorney’s fees incurred in successfully bringing its declaratory judgment action.
 
zurich.jpgIn January of 2001 a worker fell and suffered injuries while employed on a project in Uxbridge, Massachusetts. A year later he brought a negligence action against the general contractor and another subcontractor on the project. The general contractor was insured under a general liability insurance policy with Zurich American Insurance Company (Zurich). The subcontractor also had a policy issued by Worcester Insurance Company (Worcester), and was required by contract to list the general as an additional insured.

Upon filing of the complaint, the general called upon the subcontractor and Worcester to defend. They refused and Zurich defended. Zurich also brought a declaratory judgment action in the general’s name, seeking indemnification from the subcontractor and Worcester for their refusal to defend. Ultimately, the negligence case settled, with the general contributing $75,000 to the settlement.

The general contractor prevailed in the declaratory judgment action and Worcester was ordered to pay one half of both the settlement amount and the costs of defending the negligence action. However, the general contractor also sought an award of the attorney’s fees incurred to file and prevail in the declaratory judgment action, even though it was evident that it was Zurich who had paid the fees. The Superior Court judge denied the request and the general contractor appealed.

The SJC affirmed and discussed at length its reasoning. Massachusetts generally follows the customary approach to the award of attorney’s fees in civil litigation, known as the “American Rule”. In the absence of some statute or other rule, successful litigants must nonetheless pay their own attorney’s fees and expenses.

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