Free Massachusetts Workers' Compensation FAQs | Free Massachusetts Workers' Compensation Legal Documents

How Do I Know If My Employer Is Covered By Workers' Compensation?

Tue, 29 May 2007 21:19:00 GMT

All employers in Massachusetts are required by state law to carry workers` compensation insurance covering their employees, including themselves if they are an employee of their company. This requirement applies regardless of the number of hours worked in any given week, except that domestic service employees must work a minimum of 16 hours per week in order to require coverage.

How Long After An Injury Do I Have To Report It To My Employer?

Mon, 04 Jun 2007 21:51:22 GMT

For injuries on or after January 1, 1986, a claim must be filed within four years of the date an employee becomes aware of the connection between their disability and their employment. In the case of the death of an employee, the claim must be within four years of death. For injuries prior to 1/1/86, the statute of limitations is one year, regardless of the employee`s knowledge of the causal connection, although it is the burden of the insurer to show prejudice by the employee`s failure to file within one year of injury. When an employee is disabled or incapable of earning full wages for five or more calendar days due to an occupational injury/illness/death, the employer must file a Form 101 with the Department of Industrial Accidents and the company`s insurance carrier. This form must be sent within seven days (not including Sundays and legal holidays) from the fifth day of disability.

If I Am Injured On The Job Can I Choose The Doctor Who Treats Me?

Tue, 29 May 2007 21:19:00 GMT

For your first visit to the doctor or hospital your employer has the right to designate a health care provider within the employer`s preferred provider arrangement. After that initial treatment, you have the right to choose your own health care providers. You may change these providers one time without the permission of the insurer. To change providers again you will need the insurer to agree to the change.

If I Am Unable To Return To The Type Of Work I Did Before I Was Injured, What Happens?

Mon, 04 Jun 2007 21:51:22 GMT

If you cannot return to fulltime regular work or to your regular job classification due to your injury and you return to modified duty with reduced wages or reduced hours, you are eligible for temporary partial disability (TPD) benefits. These benefits are generally twothirds of the difference between your average weekly wage at the time of your injury and your current earnings, not to exceed a maximum allowed by law.

Injured workers that are able unless a union contract, or the individual`s contract of hire, requires it, an employer does not have to hold an injured worker`s job open while they are unable to work due to an occupational accident. But the workers` compensation law does require employers to give preferential treatment in the rehiring of injured workers when they are ready to return to work. The law also requires that employers make all reasonable accommodations to anyone who is deemed to be a qualified handicapped person under the statutes.

My Employer Has Denied My Claim, What Do I Do?

Tue, 29 May 2007 21:19:00 GMT

If the insurer denies the claim, stops or reduces payment once it has been initiated, the employee can file an Employee Claim form (Form 110) to request a hearing. In order to give the insurance company sufficient time to investigate the claim, an employee claim cannot be accepted until 30 days have passed from the alleged onset of disability, or the insurer has denied the claim by certified mail. There are several proceedings that can take place in this situation.

The first proceeding scheduled on a contested claim is an informal conciliation, which is held within a few weeks of the claim being received by the DIA. At conciliation an attempt is made to settle the issues in dispute. If an agreement is not reached, the claim is referred to a conference before an Administrative Judge.

The Industrial Accident Board is made up of the DIA`s Administrative Judges, who rule on disputed workers` compensation claims. The conference is the first proceeding before a judge. The insurer and the employee must be present at the conference. Following the conference, the Judge will issue an order of payment or denial. Either side may appeal this within 14 days. If the case is appealed it will proceed to the hearing stage.

At a full hearing the same Administrative Judge who presided at the conference considers all the evidence. Rules of evidence now apply, and witnesses can be subpoenaed. After reviewing all the information available, the Judge will then issue a written decision. If either party to the case believes the Judge made an error of fact, or exceeded his/her authority with the ruling, the party has 30 days from the filing date of the decision to file an appeal to the Reviewing Board.

For more information regarding denied or suspended claims you can contact the Department of Industrial Accidents at one of the following numbers.

Boston: (617) 7274900;
Lawrence: (978) 6836420;
Fall River: (508) 6763406;
Worcester: (508) 7532072;
Springfield: (413) 7841133

What Workers' Compensation Benefits Am I Entitled To?

Tue, 29 May 2007 21:19:00 GMT

All reasonable and necessary medical care for the treatment of your injury will be covered as well as medical rehabilitation in some cases. Depending on the situation you may be entitled to certain reimbursement for travel expenses.

You may also be entitled to certain weekly wage disability benefits depending on your injury. These benefits can vary depending on the nature and extent of your work related injury.

When Will My Benefits Begin And How Much Will They Be?

Tue, 29 May 2007 21:19:00 GMT

An injured worker becomes eligible for weekly compensation wage benefits when he/she has been totally or partially disabled due to an injury or occupational illness, and is incapable of earning full wages for five or more calendar days (days do not have to be consecutive; disability can be total or partial). When this happens, the employer is required to file the Employer`s First Report of Injury/Illness/Death (Form 101), in compliance with Massachusetts`s law. Once the insurer receives the Form 101, they have 14 days to pay benefits or notify the employee and the Department of Industrial Accidents (DIA) that they are contesting the claim. The insurance company can pay on a claim for up to 180 days without prejudice, during which time they can stop or modify the payments, after giving a seven day notice to the injured worker and the DIA. After the 180day paywithoutprejudice period has passed, the insurer can stop or reduce payment only for reasons specified by the workers` compensation act and regulations. The wage benefit is generally based on 66 2/3% of the injured workers average weekly wages up to a maximum weekly amount mandated by Massachusetts`s law.

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