Lowell, MA Worker’s Compensation

Massachusetts law requires employers to provide workers’ compensation insurance to employees. Workers’ compensation insurance was designed to ensure that injured employees have access to medical care, income while they are unable to work, and other benefits.

Workers’ compensation cases are different from personal injury cases, in that the injured worker doesn’t have to prove that the employer—or anyone else—was negligent. Most work-related illnesses and injuries are covered, regardless of fault.

Though that sounds simple and non-confrontational, as legislators intended. However, not every employer or workers’ compensation insurer plays by the rules. Workers’ compensation insurance carriers, like all insurers, make money by taking in more in premiums than they pay out in benefits. An experienced Massachusetts workers’ compensation attorney can help ensure that you receive fair compensation after an injury at work, and that you have access to the medical care and support you need in a timely manner.

Workers’ Compensation Benefits

Massachusetts workers’ compensation offers several different types of benefits, depending on the nature of the injury and resulting disability. These are:

• Temporary Total Incapacity Benefits, which are available to employees whose injury or illness renders them unable to work for five or more days. These benefits are payable for up to three years, and are calculated at 60% of your average weekly wage up to a cap.
• Partial Incapacity Benefits, which supplement income for workers who are still able to work, but are earning less because of the injury. For example, an employee may have been forced to switch to a lower-paying position, or to cut back work hours due to the injury. The maximum benefit available is 75% of what you would receive in Temporary Total Incapacity Benefits.
• Permanent and Total Incapacity Benefits, which are payable to workers who are permanently unable to do any kind of work due to an on-the-job injury or work-related illness. These benefits are calculated at 2/3 of your average weekly wage and may be increased by cost-of-living adjustments. There is no limit on how long you can receive Permanent and Total Incapacity Benefits.
• Medical Benefits, which are available to any covered worker requiring medical attention due to a work-related injury or illness. Once your claim has been reported, the insurer must issue you a benefits card with a claim number, so your medical providers can bill the insurance carrier directly.
• Permanent Loss of Function and Disfigurement Benefits, which compensate workers who have sustained loss of bodily functions or scarring / disfigurement of the face, neck, or hands. This benefit is distributed as a one-time payment, and is in addition to other benefits.
• Survivors’ or Dependents’ Benefits, which provide for the spouse and/or minor children of a worker who dies as a result of a work injury or work-related illness. The surviving spouse’s benefits are calculated at 2/3 of the deceased’s average weekly wage, subject to a cap. The duration of these benefits depends on the spouse’s continuing status as a dependent.

Workers’ compensation insurance also pays up to $4,000 for reasonable burial expenses when an employee is killed at work or dies as the result of an occupational illness.

Claiming Workers’ Compensation Benefits

When the workers’ compensation process goes smoothly, it plays out like this:

• You report the injury to your employer
• Your employer makes a report to the insurance company within seven days of the fifth day of lost work time
• The insurance company has 14 days to investigate
• If the insurer approves the claim, you will receive a notification of payment
• You receive your medical coverage card and begin receiving checks

Unfortunately, there are several ways this process can go wrong:

• The employer may refuse to submit or delay submission of its report to the insurer
• The insurer may not issue a determination within the allotted time
• The insurer may deny your claim
• The insurer may begin making payments during the “pay without prejudice” period, but later determine that you are not entitled to benefits

It is generally in your best interest to contact a workers’ compensation attorney at the first sign of trouble. The Massachusetts Department of Industrial Accidents recommends that you seek legal counsel if your claim is disputed, as workers’ compensation law is complex.

You can schedule a free consultation now, by calling 978-459-1792 .

We also handle New Hampshire workers’ compensation cases.