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Workers' Compensation
- What is Workers' Compensation?
- Where is the Department of Industrial Accidents located?
- What should I do if I am injured at work?
- If I am Injured at work, how long will it be until I start receiving benefits?
- What do I do if the insurer denies my claim or terminates my benefits within the 180-day period?
- If I am entitled to workers' compensation, how much will I receive in weekly benefits?
- For how long can I receive workers' compensation benefits?
- How long do I have to file a workers' compensation claim following a work injury?
- I was injured at work and learned that my employer does not have workers' compensation insurance; can I still receive workers' compensation benefits?
- An insurance company sent me a letter telling me to go for a medical examination; do I have to go?
- I have already started treatment with a doctor of my choosing; can the workers' compensation insurance company make me change doctors?
- When I was injured, I had a second part-time job. Because of my injury, I can no longer perform this job. How does this impact my workers' compensation benefits?
- I am a Union worker who was injured on a public works project. Are my fringe benefits included when calculating my Average Weekly Wage?
- If I am receiving workers' compensation benefits, can I also be eligible for Social Security Disability?
- I was injured on the job because of the mistakes made by an employee of another company; do I have any rights against the worker and his company?
- I am receiving workers' compensation benefits; is the insurance company obligated to settle my case?
- If I settle my case, will the insurance company continue to pay my medical bills?
- I was injured on the job and have been told I will never be able to return; what are my rights?
Personal Injury
Social Security Disability
- What are SSDI benefits?
- What factors are important for determining my eligibility for SSDI benefits?
- What happens if I apply for SSDI and am then rejected?
- How am I supposed to pay for an attorney to fight my claim for me?
Workers' Compensation
What is Workers' Compensation?
Workers' Compensation is a type of insurance policy taken out by employers to cover their employees' injuries that occur while at work. The benefits that are provided by employers are covered by Workers' Compensation Act which is enforced and administered by the Department of Industrial Accidents.
Where is the Department of Industrial Accidents located?
The Department of Industrial Accidents is located in downtown Boston at:
600 Washington Street, 7th Floor
Boston, Massachusetts
There are additional locations in Fall River, Worcester, Springfield, and Lawrence. Where a person lives determines which office is used for handling any workers' compensation claim.
What should I do if I am injured at work?
Following appropriate emergency medical attention, if necessary, report the injury and the circumstances of its occurrence to the employer and complete an accident report as soon as possible. When you seek medical attention, be certain to tell the doctor or medical facility how and where the accident occurred. Additionally, be sure to write down the names and contact information of any witnesses to the accident. It is very important not to sign any documents you do not understand and do not give a recorded statement without consulting an attorney beforehand.
If I am Injured at work, how long will it be until I start receiving benefits?
In order to receive any benefits from workers' compensation, you must be unable to receive your full wages for five or more work days. At the five day mark, your employer has an obligation to report the work injury to the insurer as well as to the DEpartment of Industrial Accidents. At this point, the insurer has 14 days from the employer's first report to investigate the claim and to make a decision as to whether or not they will pay benefits. Once a decision is made, the insurer has an obligation to notify you, the injured party, of their decision in writing. As a rough estimate, it can be nearly three weeks from the initial accident before an injured worker starts seeing workers' compensation benefits.
What do I do if the insurer denies my claim or terminates my benefits within the 180-day period?
If the insurer denies my claim or terminates my benefits within the 180-day period, you should consult with an experienced workers' compensation attorney who is knowledgeable about handling workers' compensation claims in order to determine what your rights are under the Massachusetts Workers' Compensation Act. Under the Massachusetts Workers' Compensation Act, an attorney is not able to charge you a fee for an initial consultation.
If I am entitled to workers' compensation, how much will I receive in weekly benefits?
The amount received in weekly benefits depends in part on how disabled a person is deemed to be as a result of a workplace accident. If a person is totally disabled, that person is entitled to 60% of his or her average weekly wage. If a person is partially disabled, an Administrative Judge from the Department of Industrial Accidents will determine the benefit rate by subtracting the current, post-injury earnings from pre-injury earnings and awarding 60% of that difference. Finally, if a person is totally and permanently disabled, he or she will receive two-thirds of his or her average weekly wage, potentially eligible for a cost of living adjustment.
For how long can I receive workers' compensation benefits?
Injuries that have taken place since December 24, 1991, when the reform went into effect, are eligible for temporary total benefits for up to 156 weeks (3 years) and then partial disability for up to 260 weeks (5 years). A person is only allowed to receive a combination of temporary total benefits and temporary partial benefits for 364 weeks (7 years). So a person cannot use all 156 weeks of temporary total benefits and then 260 weeks of total partial benefits as that is 8 years.
How long do I have to file a workers' compensation claim following a work injury?
An injured worker has four (4) years from the date he or she first determines an injury to be related to employment to file a workers' compensation claim. Once the four year mark has passed, the claim is dead.
I was injured at work and learned that my employer does not have workers' compensation insurance; can I still receive workers' compensation benefits?
Yes. The Workers' Compensation Trust Fund was established in Massachusetts to provide for employees of employers without workers' compensation insurance who have been injured on the job and are not facing medical bills and a period of disability or a reduced ability to work. The process of filing a claim with the Workers' Compensation Trust Fund is different from filing a workers' compensation claim with an insurer and so it is even more important to consult with a workers' compensation attorney in order to increase the chances that your claim will be favorably received by the administrators of the Trust Fund.
An insurance company sent me a letter telling me to go for a medical examination; do I have to go?
Yes. When you filed your workers' compensation claim with your employer and the insurance company, you accepted the obligation to show up for medical examinations. If you do not show up, your weekly benefits can be suspended or fully forfeited due to your obstruction of the investigation.
I have already started treatment with a doctor of my choosing; can the workers' compensation insurance company make me change doctors?
No. The workers' compensation insurance company cannot force you to change doctors or prevent you from receiving treatment or care from a doctor with whom you are comfortable. It is important to remember, however, that a person is allowed to change doctors in each specialty only once. For example, if an injured employee changes treating neck doctors, he or she cannot then chose a third neck doctor but he or she can change treating knee doctors.
When I was injured, I had a second part-time job. Because of my injury, I can no longer perform this job. How does this impact my workers' compensation benefits?
Under the Massachusetts Workers' Compensation Act, the total wages earned from all insured employers at the time of an injury are calculated when determining what the weekly benefits will be for that individual. So if the second, part-time job is also insured for workers' compensation, the income from those hours will also be used in calculating average weekly wages.
I am a Union worker who was injured on a public works project. Are my fringe benefits included when calculating my Average Weekly Wage?
In the majority of situations, under the Workers' Compensation Act as well as Massachusetts General Laws, employer contributions to health and welfare plans, pension plans, and annuity plans are included in determining average weekly wage. Unfortunately, union fringe benefits are not included when calculating average weekly wage.
If I am receiving workers' compensation benefits, can I also be eligible for Social Security Disability?
If you are receiving workers' compensation benefits, you may also be eligible for Social Security Disability. It is important to keep in mind that the amount awarded in Social Security Disability may be reduced by the workers' compensation benefits you are already receiving.
I was injured on the job because of the mistakes made by an employee of another company; do I have any rights against the worker and his company?
When someone other than the employer or a co-worker causes an injury, there is the possibility of filing a Third-Party Action against the responsible party. This type of action, which is separate from workers' compensation, entitles an injured party to relief for pain and suffering, which is not covered by the Workers' Compensation Act. The insured worker wishing to go through with a Third-Party Action should be aware that the workers' compensation insurer is likely to place a lien on the recovery from a negligent third-party in order to recover what the insurer spent on the injured employee. Experienced workers' compensation attorneys may be able to negotiate a reduced or compromised payback to the workers' compensation insurer rather than have the insurer collect all that it claims it is owed.
I am receiving workers' compensation benefits; is the insurance company obligated to settle my case?
There is no obligation to settle a workers' compensation case with an injured employee; however, the insurance company may offer a lump-sum settlement to the individual in order to be done with the entire claim and case. If you are offered a lump-sum settlement or other form of settlement by the insurance company, it is important not to accept the settlement agreement before consulting with an experienced attorney who will be able to explain what each term of the settlement offer means for your case. The attorney for the insurance company has no obligation to explain things fairly to an injured employee.
If I settle my case, will the insurance company continue to pay my medical bills?
Not necessarily. The specific terms of a settlement create different rights and obligations in each party and each settlement is unique. Some settlements may require that the insurance company continue to pay medical bills while others will not. The type of injury and likelihood of ongoing medical bills will have some influence in determining whether the insurance company will be willing to continue to pay medical bills.
I was injured on the job and have been told I will never be able to return; what are my rights?
Under the Workers' Compensation Act, individuals who are unable to return to their jobs after being injured and because of permanent disability have the right to seek vocational counseling. Vocational counseling is administered through the Department of Industrial Accidents. If eligible for vocational services, you may be eligible for job placement or for re-training on an effort to return you to an earning level that is close to your pre-injury wage.
Personal Injury
Social Security Disability
SSDI benefits, which are also known as Title II Benefits, are available to people who have a disability that places them within the defined meaning of "disabled" found in the Social Security Act. This definition is strictly policed and is a Federal program for providing for disabled individuals. The most basic criteria is that a person must be disable for any job for which he or she is reasonably suited within the national, regional, or local economy.
What factors are important for determining my eligibility for SSDI benefits?
In order to qualify for SSDI benefits, an individual must have worked twenty (20) of the last forty (40) quarters, better known as the five of the last ten years. This requirement may be shorter if a person who is applying for SSDI is younger. Next, there is an earnings requirement that must be met. Finally, a determination will be made based upon the extent of a person's disabling condition. This assessment includes factors like age, education, work experience, training, and any special skills a person possesses.
What happens if I apply for SSDI and am then rejected?
The most basic answer is that you have the ability to correct the application and appeal the decision. The first level of appeal is called the Request for Reconsideration. When appealing, it is important to have all of the necessary medical documents on hand and organized appropriately.
How am I supposed to pay for an attorney to fight my claim for me?
Most attorneys work on a contingent fee agreement whereby they aren't paid unless you are awarded SSDI benefits. The particulars of a contingent fee agreement vary from attorney to attorney but are all designed to allow those who lack the means to hire an attorney on an hourly rate to have his or her day in court, as the case may be.
Who determines whether I receive SSDI benefits or not?
The Social Security Administration, a federal agency, determines who receives SSDI benefits and who does not. The SSA, as it is known, has doctors who are paid to review the medical claims of those who apply for SSDI and have the ability to say "no" to any person's request for SSDI.
