Hire a Lawyer for your Mass. Disability Retirement Case

DISABILITY_RETIREMENTIn order to receive Accidental Disability Retirement (ADR) benefits in Massachusetts, an applicant must prove that he or she is permanently incapacitated from performing the essential duties of his or her position because of an injury sustained or hazard undergone while in the performance of his or her duties.

Every Massachusetts Accidental Disability Retirement case requires a certificate from a medical panel comprised of three physicians who must answer “yes” to the questions of disability, permanency, and causation. However, a medical panel certificate which unanimously states that an applicant was permanently disabled in the performance of his or her duties does not guarantee the award of a disability retirement. While the applicant’s retirement board may not generally ignore the medical panel’s findings, the retirement board is entitled to consider both the medical and non-medical evidence when ruling on a disability retirement application.

Having a lawyer represent you in a Massachusetts Accidental Disability Retirement case is important because you must convince the retirement board that you are permanently unable to perform the essential duties of your job by reason of a personal injury sustained or hazard undergone, as a result of, and while in the performance of your duties. This can sometimes be difficult to prove, depending on the facts and circumstances of the individual case.

There is no minimum age or years of service requirement to be eligible to apply for an Accidental Disability Retirement in Massachusetts. Please contact me if you believe that you can no longer perform your duties and you need to file for an accidental disability retirement in Massachusetts.

Accidental Disability Retirement Denial Reversed

The State Board of Retirement’s denial of an accidental disability retirement of a state employee was recently reversed on appeal when it was demonstrated that the injured employee was in in the performance of her duties when she was injured. She was in a motor vehicle accident while she was operating a state-owned official vehicle. When the accident occurred, she was traveling from a state-sponsored work to her office where she was going to resume working.

In the case of Burgess v. State Retirement Board, the claimant worked for the Massachusetts Executive Office of Public Safety and Security as the Director of the Office of Grants and Research of the Highway Safety Division. She swerved to avoid an accident, drove off the road, and crashed into a boulder. She suffered a traumatic brain injury in the crash and tore her right rotator cuff. She has had two surgeries since then to repair her rotator cuff. She received workers’ compensation.

The Massachusetts State Retirement Board refused to grant a regional medical panel because it determined that the claimant failed to establish that she was injured “as a result of and while in the performance of her duties,” as the retirement law requires. This case illustrates the difficulties often encounter by those seeking disability retirement benefits. Public employees who are injured at their place of employment, but not while performing any work obligation at the time of the injury, or those who are injured while traveling to work or leaving their place of employment after completing their work for the day, are not eligible for accidental disability retirement. Employees hurt while at lunch or while traveling home have been routinely denied benefits.

In this case, in reversing the denial, the Massachusetts Division of Administrative Law Appeals correctly noted that “An employee permanently injured while transitioning from one task to another may be eligible for accidental disability retirement so long as the task the employee is leaving and the task the employee is about to undertake are both employment obligations.” The Administrative Magistrate determined that the Claimant was driving between a work obligation at Fort Devens and a work obligation at her office. Therefore, she was in the performance of her duties when she sustained disabling injuries in the automobile accident.

The Smoking Prohibition

In Town of Plymouth v. Civil Service Commission, 426 Mass. 1 (1997), the Massachusetts Supreme Judicial Court held that a police officer hired after January 1, 1988 who smokes tobacco products shall be subject to mandatory termination. For positions subject to G.L. c. 31 the smoking prohibition includes any appointment whether provisional, temporary or permanent, full-time, part-time, intermittent or reserve, to a covered position from an eligible list established as the result of a civil service examination administered after January 1, 1988.

The Supreme Judicial Court ruled that based on the language used in G.L. c. 41, § 101A and the promulgated rules of the Personnel Administrator, termination was mandatory.

The purpose of the smoking prohibition is to prevent Massachusetts police officers and fire fighters from increasing their risk of hypertension and heart disease by smoking and, therefore, their eligibility for disability retirement benefits under G.L. C. 32, § 94. The prohibition does not apply to all civil service employees, but only to police officers and fire fighters who, because of the nature of their jobs, are already at high risk for developing hypertension and heart disease.

The Legislature appears to have made a policy decision, based on financial interests, that employment in these positions should no longer be open, after January 1, 1988, to persons who smoke tobacco products so that, over a period of time, police and fire departments will have a workforce free of a serious disease-causing addiction. It is common knowledge that tobacco smoking has been identified as a contributing risk factor in both of these conditions, and heart disease is a leading cause of disability retirement among public safety personnel. The Legislature apparently enacted C. 41 § 101A in an effort to reduce the number of police officers and fire fighters who obtain substantial disability benefits from public funds under G.L. c. 32, § 94, also known as the “Heart Law,” as a result of heart disease due to smoking.

Regional Medical Panel Examinations

In order to receive accidental disability benefits in Massachusetts, an applicant must establish by substantial  evidence, including an affirmative medical panel certificate, that he or she is totally and permanently incapacitated from performing all of his duties as a result of an injury sustained or hazard undergone while in the performance of his duties. The regional medical panel’s function is to answer medical questions which are beyond the common knowledge and experience of retirement board members. The medical panel plays two important roles in the accidental disability retirement application screening process. First, it acts as a gatekeeper. Second, it provides medical expertise.

Unless the panel applies an erroneous standard or fails to follow proper procedures, or unless the certificate is “plainly wrong”, the local board may not ignore the panel’s medical findings.

A medical panel consists of three (3) physicians who examine the applicant either jointly or separately. The members of the medical panel will also review medical records and information including imaging studies such as MRIs and X-rays.  It is impossible to get an accidental disability retirement in Massachusetts unless a majority of a three-member regional medical panel examines the pertinent medical facts and certifies that all of the conditions and requirements for accidental disability retirement are met.

In order to overturn an adverse decision made by a regional medical panel , the applicant must prove that the three-physician medical panel lacked pertinent medical facts or applied an erroneous standard in its conclusion. The panel doctors are not obligated to agree with opinions of other physicians and a conflict between the opinion of a regional medical panel and other physicians does not mean that the panel applied an erroneous standard.

In some cases, if the information provided by the medical panel does not provide sufficient information to the retirement board, the board has the option to submit a request for clarification to the panel. In such a situation the panel physicians will have an opportunity to further explain their opinions and conclusions by answering the board’s questions.

In situations where a two out of the three members of a properly constituted regional medical panel issue a negative certification, the application for accidental disability retirement benefits must be denied. Unless it can be shown that the panel lacked significant information or applied an incorrect standard, a retirement board cannot grant an accidental disability retirement. If the medical certification is proper, a board may not substitute its judgment for the opinion of the majority members of the panel, even if other doctors have issued contrary opinions.

ADR applicants in Massachusetts who are represented by lawyers have the legal right to have the applicant’s attorney attend the medical panel examination.

ADR Denied due to Distracted Driving

The Massachusetts Contributory Retirement Appeals Board recently upheld the denial of an Accidental Disability Retirement Application filed by a mechanic and heavy equipment operator for the Spencer Highway Department because the applicant distracted by his use of a cell phone while driving. The Worcester Regional Retirement Board (WRRB) determined that the applicant’s injuries resulted from a motor vehicle accident which was caused by his improper cell phone use. He was operating a Chevrolet Silverado pickup truck southbound on Route 31 in Spencer, Massachusetts when he rear-ended a school bus which was stopped with its red lights flashing.

The Retirement Board denied the Accidental Disability Retirement because it found that the employee’s injuries were the result of “serious and willful misconduct,” as set forth in G.L. c. 32, § 7(1). The misconduct consisted of him spending more than ten seconds attending to his cell phone while driving a heavy pickup truck and rear-ending a school bus, which was stopped in front of him and was displaying its flashing red lights.

According to the accident reconstruction report, during a period of 10.45 seconds, the employee did nothing to avoid hitting the school bus. He did not use his brakes or attempt to swerve out of the way. The pickup truck simply continued to travel at 44 miles per hour until it crashed into the rear of the school bus at that speed, pushing the bus forward 16.1 feet.

The disability retirement claimant appealed the Retirement Board’s decision to the Division of Administrative Law Appeals (DALA) and that agency upheld the Worcester Regional Retirement Board’s denial. The DALA Magistrate ruled that the claimant engaged in “serious and willful misconduct” when, while driving a three-ton truck at over 40 miles per hour, he spent at least ten seconds focusing his attention on his cell phone, to the point where he did not notice a full-sized yellow school bus stopped directly in front of him, with its blinking red lights activated, and simply drove at full speed into the rear of the bus.

The claimant appealed further to the Massachusetts Contributory Retirement Appeals Board and the Board agreed that he committed “serious and willful misconduct” such that denial of his ADR application was proper. The CRAB ruled that the claimant he has not established that his injuries resulted from his work duties. Instead, the injuries resulted from distracted driving which constituted “serious and willful misconduct” and the denial of his application was lawful.

No Accidental Disability Retirement for Horseplay

Joseph Indrisano was an operations and maintenance supervisor in the Worcester Trial Courthouse. While engaged in horseplay with his friends, he sustained a disabling injury. It was determined that the injury was not sustained in the performance of his duties, so his Accidental Disability Retirement claim was denied.

Specifically, one of Mr. Indrisano’s co-workers stood aggressively like a bear. He hunched his shoulders as if to stand his ground or to attack. He held his arms in front of him, as a weight-lifter showing off his muscles would. This caused another co-worker to back away from him.  This employee who was in this bear-like posture walked playfully towards Mr. Indrisano, who lost his balance and fell. The next day he reported the injuries which he sustained in the fall when he landed hard on his back.

In the case of Damiano v. Contributory Retirement Appeal Board, 72 Mass. App. Ct. 259 (2008), the Massachusetts Appeals Court has ruled that an employee who is injured by a fellow employee’s goofing off at work is not entitled to accidental disability retirement benefits. The goofing off can include horseplay, behavior that might turn into horseplay, as here, and other behavior.

The Magistrate ruled that physical contact between two employees is not required to uphold a denial. If hypothetically in Damiano, Police Dispatcher Teresa Damiano had successfully fled the police officer’s attempt to put her into a headlock, and the police officer never touched her, but Ms. Damiano tripped while fleeing and injured her wrist and elbow, the Appeals Court’s decision would almost certainly have been the same.

To qualify for accidental disability retirement, an applicant must prove total and permanent disability by reason of a personal injury sustained or a hazard undergone as a result of, and while in the performance of, his duties at some definite place and at some definite time. G.L. c. 32, § 7. Accidental disability retirement can be awarded only when a regional medical panel majority concludes that the applicant is incapable of performing the essential duties of the job, that the incapacity is permanent, and that the incapacity might be the natural and proximate result of the personal injury sustained or hazard undergone in the course of employment. See Malden Retirement Bd. v. Contributory Retirement Appeal Bd., 1 Mass. App. Ct. 420, 423 (1973).

It has been judicially determined that on-duty injuries sustained due to goofing off or horseplay in the workplace, which render a person unable to perform his or her essential job functions, are not sufficient grounds for accidental disability retirement benefits because the injuries were not sustained while in the performance of an employee’s duties.

 

Firefighter Awarded Accidental Disability Retirement for PTSD

Mr. Travers, a former firefighter and emergency medical technician for the Town of Winchester, was ultimately awarded an accidental disability retirement based on his claim that he suffered disabling post-traumatic stress disorder after responding to the scene of a quadruple murder.

On June 16, 2010, Mr. Travers responded to a well-being call on Windsong Lane, a quiet street in a wealthy section of the community. This call exposed him to an extremely bloody and gory scene. Two days after exposure to this horrific crime scene, Boston Fire Department Critical Incident Team leader singled him out from others who had been at the scene and referred him to the Massachusetts General Hospital Critical and Emergency Psychiatric team. Mr. Travers experienced a litany of psychiatric symptoms and underwent hospital admissions for Post-Traumatic Stress Disorder. He was prescribed psychiatric medication.

He underwent in-patient and out-patient therapy and reported experiencing nightmares, agitation, an inability to remember or focus on tasks, and a lack of appetite. He was examined on March 8, 2013 by a regional medical panel composed of three psychiatrists, who unanimously determined that he was disabled, the disability was likely to be permanent, and it might have been the natural and proximate result of a personal injury he sustained while in the performance of his duties.

The DALA Magistrate overturned the local retirement board’s denial of Travers’ disability retirement application. It ruled that he was permanently disabled by PTSD caused by his reaction to being exposed, while in the performance of his duties, to the bloody remains of two people murdered at a home on Windsong Lane. He has demonstrated that he is eligible for accidental disability retirement. This determination was made notwithstanding his eventual return to work after the trauma exposure and his pre-existing psychiatric history as well as his arrest for a weapons charge.

Light Duty Blocks Disability Retirement

In the case of Cesaitis v. Worcester Retirement Board, which was decided on June 2, 2017, Administrative Magistrate Judithann Burke of the Massachusetts Division of Administrative Law Appeals recently upheld the denial of an Accidental Disability Retirement Claim where a Worcester cafeteria worker, who agreed to a modification of his job duties because of a back problem, performed duties not listed in the agreement.

After agreeing to changes in his job description to relieve him from having to perform strenuous activities, the employee took it upon himself to exceed the limits of the new job description and go beyond the physical restrictions set forth in the agreement with his employer. Rather than performing the only the limited and doctor-sanctioned duties set forth in the agreement, he routinely failed to rest and performed bending and lifting activities in order to place items in coolers. He did so because he felt responsible to make sure all of the activities of the cafeteria were performed. The Administrative Magistrate found this to be commendable. However, she ruled that by bending and lifting he undertook work that was inconsistent with the previously agreed upon accommodations designed to address the employee’s back pain.

The Magistrate determined that “in light of the Petitioner’s refusal, (notwithstanding his thought processes and motivations) to restrict his work activities to those set forth in the accommodated job description… the Petitioner does not qualify for an accidental disability retirement.”

The denial is based on the premise that a medical panel is allowed to consider reasonable accommodations in determining whether, under G.L. c. 32 § 7, a public employee is “unable to perform the essential duties of his job and that such disability is likely to be permanent.” There is a duty imposed on the employee to seek a reasonable accommodation from his or her employer to address any temporary or permanent limitations caused by the injury.

It is important to note that this was a civilian non-public safety position and in the case of a Massachusetts firefighter or police officer, there is likely no light duty or reasonable accommodation which would allow an otherwise disabled employee to continue to perform the essential functions of his or her public safety position.

 

Police Officer’s Disability Retirement Claim Denied

Fall River Police Officer Wayne Rosario was recently denied accidental disability retirement benefits because he failed to satisfy the two-year notice requirement established by G.L. c. 32, § 7(1). The Fall River Retirement Board denied Rosario’s Accidental Disability Retirement claim based on its determination that his claimed psychological injury did not occur within two years prior to his application, and he did not file any injury reports or incident reports about a psychological injury prior to the two-year notice period. The incidents relied on in Mr. Rosario’s application occurred well before the two-year period and only physical injuries were reported.

A hearing was held before the Division of Administrative Law Appeals in Boston, Massachusetts and that hearing resulted in a decision upholding the denial of benefits.

Rosario may have been able satisfy the two-year notice requirement if there is a record of a mental injury he sustained or a hazard undergone on file in the official records of his department. Such records are often injured-on-duty records for which G. L. c. 41, § 111F benefits are received, an employee-filed injury report or an employer-filed injury report sent to the local retirement board.

There were records of physical injuries sustained but not evidence of any mental injuries. Therefore, Rosario could only rely on psychological injuries arising within the 2-year period immediately preceding the filing of his ADR Application.

In rejecting his claim for an accidental disability retirement, the Magistrate hearing Rosario’s case ruled as follows: “his focus on past events and his animosity toward his fellow officers and supervisors as shown in his testimony and Mr. Rog’s records lead me to conclude that Mr. Rosario was dissatisfied with being a police officer and wanted to leave the FRPD. He did not want to accept a regular retirement pension, however, because it was ‘a joke. Failure to get along with coworkers and superiors is not so uncommon as to constitute an ‘identifiable condition.’”

Career Incentive Payments not Regular Compensation

Upon retiring from public service, a member of the Massachusetts Public Employee Retirement System is entitled to a superannuation retirement allowance that is based on the member’s average annual rate of regular compensation for his last three years of employment or for his three highest paid consecutive years of service. Regular compensation is generally considered to be an employee’s base salary.

Because of the above-described retirement formula, disputes sometimes arise regarding what is considered “regular compensation” for retirement purposes. A series of decisions have progressively narrowed the definition of regular compensation. For example, in the recent case of Burke v. Teachers Retirement Board, certain payments that Ms. Burke received were determined to be “career incentive payments” and, therefore, not regular compensation.

Ms. Burke was a member of the Massachusetts Teachers’ Retirement System Pursuant to her contact with the Mystic Valley Regional Charter School, she was to receive payments for remaining in her position and the total amount of these payments was based on her staying employed with the Charter School. Ms. Burke claimed that the payments were longevity payments and, therefore, countable towards her regular compensation calculation for retirement purposes.

Certain bonuses are considered regular compensation and not countable towards retirement. Likewise, 807 CMR 6.02 (2)(e) explicitly excludes “amounts paid as a career incentive which do not become part of the member’s base salary” from calculations of regular compensation.

It was determined that the payments made to Ms. Burke for fulfilling her yearly contracts with MVRCS were paid as career incentives and are not part of her base salary. For payments to be included as longevity payments for purposes of regular compensation calculation, they must be paid on a non-contingent basis.

These payments do not meet the “non-contingent” requirement of a longevity payment because they are contingent upon the teacher’s fulfillment of the yearly school contract. Ms. Burke received these payments on the condition that she continued working beyond certain dates that were specified in her contracts. These payments would have to be returned to MVRCS along with payment of liquidated damages if Ms. Burke did not work past the required dates. The payments themselves were not based solely on Ms. Burke’s number of years of service. Rather, the payments were made if Ms. Burke remained employed with MVRCS throughout each of her yearly contracts. These payments were intended as an incentive to retain Ms. Burke’s employment throughout the school year and are not part of her base salary.

Police Officer Denied Disability Retirement

The Division of Administrative Law Appeals recently upheld the Haverhill Retirement Board’s denial of an application for accidental disability retirement on the grounds that there is no evidence that the applicant’s heart condition disabled him from performing his essential duties on the last day that he worked. The applicant, John Rogers, retired because the police chief agreed to end an internal affairs investigation into an on-duty extramarital affair that he was conducting if Rogers agreed to retire.

Rogers cited a hazard undergone and noted “heart attack, coronary heart disease, hypertension, hyperlipidemia, stent” as the basis for his claim. He cited incidents that occurred on January 9, 2011 (“heart attack”) and February 26, 2011 (“hospitalized due [to] chest pain and stress related”). He also claimed that he was exposed to the “hazard” from “October 2010 to present.” (Stipulation; Ex. 4.) Under description of the hazard, he listed “heart attack, panic attack, anxiety attack, sharpness of breath, chest pain, dizziness.”

Rather than face a disciplinary proceeding that could result in his termination, Rogers agreed to retire. He filed an application for accidental disability retirement under G.L. c. 32, §§ 6, 7, and 94, the so-called “Heart Law.” He claimed that he suffered a “heart attack, coronary heart disease, hypertension, hyperlipidemia, and stent” as the basis for his ADR claim. He further alleged that he suffered, “heart attack, panic attack, anxiety attack, sharpness of breath, chest pain, and dizziness.”

After completing an internal affairs investigation, Haverhill Deputy Police Chief Thompson wrote a report wherein he concluded that Rogers violated ten different Haverhill Police department rules and regulations, including ones having to do with immoral conduct, neglect of duty, unsatisfactory performance, vehicle operations, truthfulness, and confidentiality. Deputy Thompson recommended that Rogers be terminated, but he noted: “Due to the fact that Lieutenant Rogers retired effective June 23, 2011 no further action will be taken on this investigation.”

Rogers wrote that Rogers “has a history of acute myocarditis complicated by acute myocardial infarction requiring stent placement. Due to the residual effects of his myocardial infarction, he continues to have symptoms which limit his physical activity. Specifically, he was no longer able to perform physical excursion duties prior to his retirement date of June 23, 2011.”

The Chief of Police wrote, “Prior to this retirement submittal Rogers had been on full non restricted duty dating back to 2/9/11. During this time frame he worked 65 regular work shifts, 143 hours of overtime and 98 hours of traffic direction/private detail assignments…. I believe that as a result of his early departure from city employment Rogers is attempting to obtain a medical disability pension. Rogers never advised the city of any potentially serious medical issues or health concerns after his return to unrestricted duty. This disability claim only surfaced after being faced with the possibility of a termination hearing. Rogers continued to aggressively work shifts, overtime, details as well as maintain a law practice from his return to duty up until his departure from city employment. I strongly oppose this request for a disability pension. It is my belief that this claim is completely and unequivocally without merit and would unjustly provide a significant benefit to Rogers. Should this request be approved it would be a huge disservice to the entire Haverhill Retirement System.”

The Division of Administrative Law Appeals ruled that Rogers did not made out a prima facie case for accidental disability retirement, and thus he was not entitled to examination by a medical panel. The decision of the Haverhill Retirement Board denying his claim is affirmed. There is no reliable evidence in the record that Rogers was disabled as of the last day that he performed his duties.