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Decision Brian Weisner v. American Architectural Iron

Date: 03/12/2019
Organization: Department of Industrial Accidents
Docket Number: DIA Board No. 017266-02
Location: Boston
  • Employee: Brian Weisner
  • Employer: American Architectural Iron
  • Insurer: National Union Fire

FABRICANT, J.  The employee appeals a decision denying his claim for the maximum penalty pursuant to G. L. c. 152, § 8(1)1.The employee had asserted the insurer failed to comply with a § 10A conference order to reimburse him for payment of certain prescription medications.  The judge found the employee did not follow the proper filing procedure to perfect his claim pursuant to 452 CMR § 1.07(2)(b)2 . For reasons discussed below, we reverse the decision.

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1  General Laws c. 152, § 8(1), provides, in relevant part:

Any failure of an insurer to make all payments due an employee under the terms of an order, decision, arbitrator's decision, approved lump sum or other agreement. . . within fourteen days of the insurer's receipt of such document, shall result in a penalty of two hundred dollars, payable to the employee to whom such payments were required to be paid by the said document; provided, however, that such penalty shall be one thousand dollars if all such payments have not been made within forty-five days, two thousand five hundred dollars if not made within sixty days, and ten thousand dollars if not made within ninety days.

2  452 Code Mass. Regs. § 1.07(2)(b) states:  

Pursuant to the provisions of G.L. c. 152, § 7G, the following documentation must be attached to a claim for benefits or complaint for modification or discontinuance of benefits before it will be processed by the Office of Claims Administration:

(b) Claims for penalties under G.L. c. 152, § 8(1) shall be accompanied by a copy of the order, decision, arbitrator’s decision, approved lump-sum or other agreement or other relevant document(s) with which it is alleged the insurer has failed to comply, together with an affidavit signed by the claimant or the claimant’s attorney attesting to the date payment was due, the date, if any, on which payment was made, and the amount of the penalty the claimant is owed.

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