Workers Compensation FAQs:
The workers’ compensation system is a plan designed to ensure that workers are protected by insurance if they’ve been injured on the job or develop an occupational disease.
Am I automatically eligible for workers’ compensation?
Under the Massachusetts Workers’ Compensation Act, most Massachusetts workers are eligible to receive workers’ compensation. It doesn’t matter how long you’ve been on the job, you are eligible from the first moment you begin work.
Certain categories of workers are not covered by workers’ compensation, however. These include part-time or seasonal workers, independent contractors, employees of charities and non-profits that are entirely staffed by volunteers, and federal employees.
What workers’ compensation benefits am I entitled to receive?
Workers’ compensation generally pays for any reasonable and necessary medical treatment arising from an on-the-job injury or occupational illness. If you qualify, it also pays for a percentage of wages you’ve lost due to missed days of work. In some cases, you may also be entitled to vocational retraining.
When am I entitled to receive payment for lost wages due to a job-related injury?
You may receive compensation for lost wages once you’ve missed 5 full or partial calendar days of work due to the work-related injury. You will not be compensated for those first 5 days missed unless you are incapacitated and out of work for 21 days or more. If you miss work for more than 5 days but less than 21, you will only receive compensation for wages lost starting from the 6th day.
How do I start the workers’ compensation claims process?
First, you need to notify your employer of your injury or illness. Next, your employer must file the Employers’ First Report of Injury or Fatality (Form 101) with the Department of Industrial Accidents (DIA) and your employer’s insurance carrier within seven days from the 5th day of lost time due to injury or illness. You will receive a copy of this report once it is filed. If your employer does not send Form 101 to its insurance carrier within 30 days of your injury, you must send the form to the carrier yourself.
When will I start receiving checks?
If your employer’s insurer agrees to pay the claim, you should start receiving checks within three to four weeks after your injury or illness.
How much compensation am I entitled to receive?
The amount depends on the degree of your incapacitation. If you are totally incapacitated, you will be able to receive up to 60% of your pre-tax, pre-benefit average weekly salary. This is based on your total gross earnings for the 52 weeks prior to your date of injury. If you are partially incapacitated, you can receive up to 75% of what your weekly temporary benefits would be. If you are permanently and totally incapacitated, you can receive two-thirds of your average weekly wage based on the 52 weeks prior to your work-related injury.
How long can I receive benefits?
For total incapacitation, you can receive benefits for up to 3 years. For partial incapacitation, you can receive benefits for up to 5 years. Workers who are permanently and totally incapacitated can receive benefits for as long as they are disabled.
My claim was denied by my employer’s insurer. What should I do now?
About 50% of all workers compensation claims are denied. You have the right, however, to file a claim with the DIA to contest the denial. If you do so, the DIA strongly recommends obtaining a Massachusetts workers’ compensation attorney to help you with the dispute process. You will have to complete an Employee’s Claim Form (Form 110), attaching any medical evidence of that supports your claim and a description of when and how your injury occurred.
Once you send the completed form to the DIA, you will receive a date for a Conciliation meeting to try to reach a voluntary agreement with the insurer. If no agreement can be reached, you will have a Conference with an Administrative Judge, where you’ll be permitted to argue for your right to receive workers’ compensation benefits. A decision as to whether to grant benefits will be made at the Conference, but can be appealed by either side at a subsequent Hearing.
How can a Massachusetts Workers’ Compensation attorney help me?
A skilled workers’ compensation attorney can provide critical help if your employer’s insurer denies your claim, or if you believe you are not receiving the full benefits to which you are entitled. Your lawyer will ensure that all forms are completed accurately and in a timely manner, and determine whether you are eligible for additional benefits. Your lawyer will also fight for your interests during the Conciliation, Conference and Hearing, as appropriate. It’s your lawyer’s goal to ensure that you receive all the workers’ compensation benefits you need and deserve.
If you have any additional questions about workers’ compensation in Massachusetts, we’d be happy to answer them. Please contact Massachusetts workplace injury attorney Peter Ventura for a free consultation today. Call 508-755-7535, or contact us on online.