Worker's Compensation

The Massachusetts Workers’ Compensation Act, codified at Massachusetts General Laws Chapter 152, attempts to compensate workers for injuries suffered on-the-job, regardless of whether the worker’s employer was to blame for the injury. The law also forbids workers from suing their employers in court, under the jury system, if the employer is to blame for the worker’s injury.

The nice part of Worker’s Compensation is that workers will be compensated for an injury, even if it the injury was caused by their own carelessness, rather than their employer’s. The downside of Worker’s Compensation is that workers lose their right to sue their employers in court. In effect, the net result is that workers in Massachusetts virtually always recover for their on-the-job injuries, however, the amount that some workers recover is much smaller than if they were allowed to sue in court and receive a jury trial on a negligence claim.

It should be noted that the Worker’s Compensation Act generally only forbids lawsuits brought against the employer. It does not prohibit so-called “third-party claims.” So, for example, if a worker severs a finger on-the-job while using a defective table saw, he cannot sue his employer in court but he may bring a products liability action against the saw’s manufacturer because the saw was defective. This claim against the saw’s manufacturer would be called a “third-party” claim. In other situations, a third-party claim may be brought against a landowner, a project manager or another contractor that was on the job.

What is the first thing I should do if I am injured?

Contact an attorney at your earliest opportunity. An attorney can fill out the Department of Industrial Accident’s Form 101 for you. This form gets the ball rolling on your claim. The insurer then has fourteen days to respond.

When should I start receiving a check?

If the Worker’s Compensation insurance company that your employer uses agrees that it is liable, the insurer will send you an Insurer’s Notification of Payment – Form 103. You will then start receiving your checks. Generally speaking, this happens three to four weeks after your injury.

Unless you miss more than 21 days of work because of your injury, you will not receive benefits for the first five days that you missed.

An important note: just because the insurance company agrees to start paying your benefits does not mean that the insurance company is admitting liability and admitting that they owe you anything. In fact, the first six months of your case are a “Pay Without Prejudice” period, meaning the insurer can pay you but later change its mind that it owes you anything.

What if the Worker’s Compensation insurer denies my claim?

Contact an attorney.

What is the process like?

If the insurance company disputes the benefits, there will be a very informal meeting between your attorney, the insurance company’s attorney and a representative from the Department of Industrial Accidents. This informal meeting is called a “Conciliation” is an attempt to reach a mutually agreeable settlement.

If a settlement is not reached, the case proceeds to a Conference before an Administrative Judge. At the end of the Conference, the judge will either tell the Worker’s Compensation insurer that it has to pay your benefits or rule that they are not legally required to do so.

If you lose at the Conference, you should appeal in order to receive a Hearing. The Hearing is a more formal proceeding. There are live witnesses and the rules of evidence are followed.

If you lose at a Hearing, you may appeal to a Reviewing Board, made up of six Administrative Law Judges. Reviewing Board decisions can be appealed to the Massachusetts Appeals Court.

Are Worker’s Compensation benefits taxed?

No. They’re one of the few things in life that are tax-free.

Will I have a job when I get back from comp?

The Massachusetts Worker’s Compensation Act does not require that your employer keep a position open for you. However, if you are able to work at a later date, § 75A requires that you be given preference in rehiring.

Is there a minimum amount of work I must miss before applying for Worker’s Comp?

Technically, you need to have missed five or more days in order to be eligible for Worker’s Comp. But the five days that you miss don’t have to be back-to-back. And missed half-days also count.

Even so, if you’ve been seriously injured and know you’re going to miss a lot of work, you should contact an attorney ASAP so that he or she can get the paperwork filled out.

What about my health insurance and other benefits that I get from work?

There is no cut-and-dried answer to this because there is no obligation for your employer to continue your health insurance or any other fringe benefits.

ADDITIONAL RESOURCES

Survivors/Dependents Benefits (Massachusetts General Laws c. 152 § 31)

Temporary Total Incapacity Benefits (Massachusetts General Laws c. 152 § 34)

Permanent and Total Incapacity Benefits (Massachusetts General Laws c. 152 § 34A

Partial Incapacity Benefits (Massachusetts General Laws c. 152 § 35)

Permanent Loss of Function and Disfigurement Benefits (Massachusetts General Laws c. 152 § 36)