The Massachusetts workers' compensation system provides workers with a valuable safety net. If you succumb to a work-related injury or illness, workers' comp benefits will cover your medical bills and provide you with partial wage replacement.
But, if you've been injured on the job, you likely have many questions. When will your benefits begin? How much will you receive? What if your employer's workers' comp insurer disputes your claim? Knowing the basics can help get you on the path to recovery.
Payment for Undisputed Workers' Comp Claims Starts in Three to Four Weeks
If you have a work-related injury or illness that causes you to lose work time of five or more full or partial calendar days, your employer is required to file a form with the Department of Industrial Accidents and with their workers' comp insurance company. Your employer must file this form within seven calendar days from the fifth day of your disability. Then, the insurance company has 14 calendar days after receiving the form to investigate your claim and decide whether or not to pay it.
If the insurance company approves your claim, you should get your first weekly check three to four weeks from the date you reported your injury to your employer. You will also get an insurance card and claim number that you can use for medical treatment.
However, if the insurance company denies your claim, you might have to wait longer than three to four weeks for your money. There are four stages in the workers' comp dispute process within the Department of Industrial Accidents. The first two are conciliation and conference; both are essentially informal discussions. While these stages can be productive, you should consult with a workers' comp attorney before accepting any settlement offer, as the insurer may try to undervalue your claim.
If a resolution is not reached in the first two stages, the dispute progresses to a hearing, a formal proceeding much like a trial where evidence is presented to an administrative judge. Finally, if either party appeals the hearing, the case is presented to a review board of three administrative law judges who will examine the hearing transcripts and may ask for legal arguments.
Full Medical Benefits and Partial Wage Replacement
Workers' comp medical benefits cover the full cost of treatment for your work-related injury or illness. If you are able to transition to work in a different job, workers' comp may also cover vocational rehabilitation (job testing and counseling, job placement assistance, workplace modifications, and training).
When it comes to your cash benefits, the nature of your disability and your previous earnings determine the amount. If you are fully prevented from working but your disability is only temporary, you will get a weekly cash payment equal to 60 percent of your average weekly pay up to a maximum rate set by the state. If you are permanently disabled as a result of your workplace injury or illness, you will receive benefits equal to two-thirds of your average weekly wage for as long as you are unable to work. If you are only partially disabled and are able to work part time, you will get a portion of these benefits.
If your injury or illness resulted in permanent loss of a body function or scarring on your hands, face or neck, you can also get a one-time cash payment in addition to your weekly workers' comp benefits.
Get Legal Help From a Workers' Compensation Attorney
Getting the workers' compensation benefits you deserve is not always straightforward. If your employer's workers' comp insurer denies your claim, or will only agree to pay partial benefits, your case will hinge on the strength of your legal arguments.
Fortunately, you do not have to fight workers' comp insurers alone. An experienced, knowledgeable workers' comp attorney can make the case for your benefits, and help you get the cash you deserve as soon as possible. If you've been injured on the job, talk to a workers' comp attorney today.