WHAT IS ACCIDENTAL DISABILITY RETIREMENT?

Accidental disability retirement, sometimes abbreviated to “ADR,” is a benefit for Massachusetts public workers that helps workers who get badly hurt while doing their jobs and cannot work again. Employees of all kinds – including public employees – are covered by various workers’ compensation laws. When a private employee is receiving workers’ compensation benefits, and their injury is decided to be total and permanent, the system often swaps the worker to Social Security Disability Insurance benefits (“SSDI”). However, public employees in Massachusetts are usually not covered by SSDI. Instead, Massachusetts created its own system for public workers – such as police officers, firefighters, teachers, custodians, DPW laborers, etc.

What is incapacity?

Incapacity means that you can no longer do your job’s main tasks, or that your condition keeps you from performing your duties without a high risk of hurting yourself again. Both physical and mental injuries can form the basis for an ADR. Physical disabilities include shoulder injuries like rotator cuff tears, as well as lower back injuries, hip injuries, and knee injuries. Also, police officers, firefighters, and EMTs often suffer from mental injuries like Post-Traumatic Stress Disorder (“PTSD”), depression, and anxiety, which can all form the basis for ADR claims. If a doctor says that your condition or injury prevents you from working without a high risk of reinjury, then it can form the basis for an accidental disability retirement application.

What does permanent mean?

Permanent means that your condition or injury is not expected to get better, and that there is no reasonable medical treatment available could improve your condition to the point where you can return to work. In some cases, permanence is simple to understand. For example, it is easy to conclude that a condition is permanent where a worker has suffered a serious injury resulting in an amputation due to an industrial accident. But sometimes permanence is harder to show, like in cases where a doctor recommends that a worker have surgery to treat a condition. Whether or not a school custodian can return to work after a rotator cuff repair surgery, or if a highway laborer can continue to perform his job after a lumbar fusion, are hotly contested medical questions.

What is causation?

By far the most contentious ADR cases involve issues surrounding causation (i.e., whether a specific incident caused the permanent disability). Like with permanence, causation is sometimes an easy question to answer: a firefighter who breaks their leg in a fall while climbing down a ladder at a housefire has clearly suffered a specific personal injury. But some injuries, like rotator cuff tears or arthritis, are difficult cases. Doctors and lawyers often disagree whether a specific incident was bad enough to cause an injury, or if normal age-related wear and tear caused the injury.

The law regarding causation in ADRs is complicated and confusing because wear and tear injuries may not form the basis for an ADR. “Hazards” are identifiable conditions that are not shared by many jobs, such as exposures to asbestos, as well as exposure to life threatening or traumatic events. However, manual labor is not considered a “hazard” because there are many jobs that perform heavy and physical manual labor. Thus, even if you have spent the last 30 years performing heavy labor on your employer’s behalf, there needs to be a specific incident that results in the permanent disability – a “straw that breaks the camel’s back.” These types of cases are where an attorney with years of experience handling accidental disability cases can be crucial in proving your case.

Should you hire a lawyer for your ADR case?

Even if you think that your ADR is simple, it is important to remember that every case is different. Insurance companies fight claims tooth and nail to avoid paying out benefits, and retirement boards are no different. Just because you won your workers’ compensation case does not mean that your ADR is a “slam dunk.” Consulting an attorney that is knowledgeable about this complicated and difficult area of the law will get you on track to receiving the benefits to which are entitled, and Kenyon Legal, P.C. can help you navigate these complicated issues.