What is Workers’ Compensation?
Workers compensation is a method of providing compensation for workers that have been injured while working. The idea behind workers’ compensation is that an employee will be guaranteed a specified amount of compensation for his injuries, and the company that has hired the employee will not suffer major financial loss as a result. An employee does not have to prove fault when covered by workers compensation to receive benefits. In the State of Massachusetts, every company is required to to provide workers’ compensation coverage for its workers. This, however, replaces employees’ rights to sue their employers for personal injury claims in most cases.
I’ve Been Injured at Work in Massachusetts, What Should I Do?
- Receive medical attention and report your injury. If the situation is an emergency, receive medical attention as soon as possible. Tell every physician, nurse, or emergency medical technician that is tending to your injury that you received your injury while at your job. If it is not an emergency, inform your employer that you are injured as soon as possible. When you do notify your employer, make sure to hand her a written notice and to keep a copy of this notice for yourself. You must be quick in this process because you will only have five days after you discover (or should have known about) your work-related injury to report it to your employer and file a claim. Your employer will then need to fill out an Employer’s First Report of Injury or Fatality form (101 form) and deliver it to her insurer.
- Visit an approved doctor. Your employer will let you know which doctor to visit in order to examine and treat your injury. This doctor will then be responsible for further treatment of your injury, unless you decide to choose a different doctor approved by your employer’s insurance provider. If you are approved to receive benefits for your injury, you should expect to receive compensation within 5-14 days after your employer’s workers’ comp carrier has been notified.
Remember to hold on to any documents, records, or bills throughout this process, as they will be useful later if you are denied compensation.
What Kind of Benefits Can I Receive for Workers’ Compensation in Massachusetts?
Workers’ Compensation will cover any relevant medical cost until your injury has completely healed. This will also include reimbursement for medication costs and transportation. If your injury stops or limits you from working, workers’ compensation will also provide income benefits including:
- Temporary Total Incapacity Benefits. If you cannot work for five full (or partial) days or more (these days do not have to be consecutive), you could qualify for Temporary Total Incapacity (TTI) benefits. TTI benefits are equal to 60 percent of the total average weekly wage that you earned before your injury. You can receive TTI benefits for up to 156 weeks (three years) after your injury. You will not be paid for the first five days after your injury, unless your impairment lasts longer than 21 days.
- Partial Incapacity Benefits. If you can still work, but have a reduced pay or have reduced hours due to your injury, you may qualify for Partial Incapacity (PI) benefits. PI benefits are equal to (up to) 60 percent of the difference of the employee’s average weekly wages (current wage subtracted from wage before the injury). However, if you qualify for TTI benefits, you will only receive (up to) 75 percent of what your TTI benefits would be. You can receive PI payments for up to 260 weeks. Although, you can receive up to 520 weeks of compensation if the judge ruling over your case finds that you have sustained a permanent loss of 75 percent or more of your bodily function.
- Permanent and Total Incapacity Benefits. If you have suffered a permanent disability because of your injury that stops you from working, you may qualify for Permanent and Total Incapacity (PTI) benefits. PTI benefits are equal to two-thirds of your average weekly wage prior to your injury based on a 52 week period of employment before your injury. Fortunately, this payment also cannot be less than 20 percent of Massachusetts’ average weekly wage ($251.294). You will be paid PTI benefits for as long as your impairment exists.
- Permanent Loss of Function and Disfigurement Benefits. Permanent Loss of Function and Disfigurement (PLFD) is not an income benefit, but is available if your injury results in permanent loss of certain specific bodily functions. PLFD benefits are also available if your hands, neck or face are scarred or disfigured as a result of your injury. How much and how long you will be compensated for PLFD depends on the area of the injury on your body and the injuries extent as described in Massachusetts General Laws, Section 36.
I’ve Been Denied Massachusetts Workers’ Compensation Benefits, What Should I Do?
It is your legal right to be compensated for any injury that you have sustained that is directly related to your work as an employee under Massachusetts General Laws, Chapter 152, Sec. 25A.
It’s possible that there was a misunderstanding somewhere in the claims process, as it is a very complicated process. You should start by contacting the Massachusetts Department of Industrial Accidents (DIA), which can inform you about your options and assess whether the proper steps have been made to file a claim. If you are still denied compensation, or still have not received compensation after 30 days from the date of your injury, the next best step will be to retain an experienced Massachusetts workers’ compensation attorney.
A workers’ compensation attorney will assess whether you have a valid claim, walk you through the claims process, and represent you in front of the DIA if the case goes to a hearing. Workers’ compensation attorneys do not charge their clients up front, and will be paid only on contingency. Your employer’s workers’ compensation carrier will have an attorney if the case goes to trial, so you should too.
Workers’ Compensation Guide (en Espanol)