Workers' Compensation FAQs part 2

What is workers’ compensation?

Workers’ compensation is a form of protection for workers. Employers must purchase workers’ compensation insurance for their employees. If an employee is injured at work or while performing work duties, workers’ compensation will cover his/her medical bills and pay compensation for other losses including disability benefits.

Who qualifies for workers’ compensation?

Employees throughout the state of Massachusetts qualify for workers’ compensation benefits if they are injured as a result of their jobs. Independent contractors do not qualify for workers’ comp benefits. In some cases, however, a worker will be incorrectly classified as an independent contractor when he/she is really an employee. If you suspect your employer has misclassified you as an independent contractor and if you have experienced a work injury, you should contact a Massachusetts workers’ compensation lawyer for assistance.

What is a covered injury?

Any type of injury that occurs as a direct result of doing work can constitute a covered injury for workers’ compensation purposes. This can include repetitive stress injuries that are caused or worsened by your job, as well as illnesses that develop due to toxic exposure. Injuries and illnesses that develop off-site of your normal work environment can also qualify as covered work injuries if they developed when you were performing required work.

What if my employer is not properly insured?

Employers are required by law to have workers’ compensation insurance for all covered employees. If your employer does not have the proper coverage, then the Workers’ Compensation Trust Fund will stand in for your employer and the Trust Fund will provide coverage for medical costs and other compensation that you are owed from workers’ compensation.

How long do I have to file a workers’ compensation claim?

Your claim must be filed within four years from the date that you first determine your injury is work related. If more than four years has passed, you may no longer file a workers’ compensation claim.

What if a work injury causes death?

If a person is killed as a result of work injury, eligible family members including spouses and minor children may receive workers’ compensation benefits on behalf of the deceased. These benefits can include coverage for the costs of a funeral.

What types of benefits am I entitled to under workers’ compensation?

Workers’ compensation covers medical costs as well as a portion of your lost wages. If you are temporarily disabled or permanently disabled due to a work injury, workers’ compensation provides ongoing disability benefits. These ongoing disability benefits may be for total or partial disabilities. If you have suffered certain specific types of injuries such as disfigurement or the loss of a limb, you will also get a specific amount of compensation as determined by workers’ compensation laws in Massachusetts. For a comprehensive understanding of the types of benefits you will receive in your specific situation, it is advisable to speak with a workers’ compensation attorney.

How much work do I need to miss to receive workers’ compensation benefits?

In order to begin receiving lost wages benefits, you must miss at least five calendar days of work due to your work injury. If you have missed more than 21 days of work as a result of a work accident, then your employer will need to retroactively pay you for the first five days of missed work as well. All medical costs should be covered.

What is the difference between total and partial disability?

Total disability benefits are paid if you have been rendered completely unable to work due to your work injury. If you are disabled but can still work at a different job or under restricted duty, then you may be considered partially disabled instead of totally disabled. Partial disability benefits are paid if your disability causes your income to be reduced. For instance, you may make less at a light-duty job than you did at your previous position that you held before you were injured. If this is the case, your disability benefits payments will equal a percentage of the difference between the amount you are currently making at your new job and the amount you were making before suffering an ongoing impairment.

Can I choose my own healthcare providers?

The law in Massachusetts allows you to choose your own physicians or healthcare providers for work injuries. However, if you have signed an employment contract or collective bargaining agreement with your employer, the agreement may contain provisions giving your employer the right to send you to a doctor of the employer’s choosing. Outside of such an agreement, however, your employer cannot require you to go to a doctor they select nor can your employer require you to change physicians.

When do I begin receiving workers’ compensation benefits?

When you have informed your employer of a work injury, your employer must file Form 101. Once this form has been filed, your employer’s workers’ compensation insurer has 14 calendar days to either send your first check or to contest your claim and provide the stated reason for your workers’ compensation claim denial.

Are workers’ compensation benefits taxable?

Workers’ compensation benefits are not taxable at the federal level nor will you pay state tax in Massachusetts.

What should I do if my employer or my employer’s insurance company denies my workers’ compensation claim?

If your employer denies your workers’ compensation claim, there is an appeals process. There are several different levels of appeal and there are specific steps to follow and deadlines to meet. If you have received a claims denial, it is absolutely imperative you contact a Massachusetts’ workers’ compensation lawyer right away so that you can get assistance with the appeals process.

How does a workers’ compensation lawyer get paid?

Workers’ compensation lawyers work on a contingency fee basis so they are paid only if you recover compensation from your employer. The amount and type of compensation received by a workers’ compensation lawyer will vary depending upon how your claim is resolved. If the case goes to court then the insurer could be ordered to pay attorney’s fees to your lawyer. If you settle your workers’ compensation claim and a lump sum settlement agreement is reached, then your attorney typically will be paid by a percentage of your settlement. The percentage is capped by law.

Can I sue my employer?

Because of the workers’ compensation system, you are not able to sue your employer for a work injury. Instead, you must use the workers’ compensation system to obtain your compensation from your employer for a work injury. However, in some cases, a third-party liability claim may be filed against someone other than your employer, such as a subcontractor.

Can I collect damages for pain and suffering?

Unlike in a traditional personal injury case, workers’ compensation doesn’t cover pain and suffering. The benefits are, instead, intended to make sure your medical costs are paid and your family supported. You can, however, receive designated amounts of compensation for certain types of injuries.

What if a third party was responsible for my injury?

If a third party was responsible for your injury, such as a products manufacturer who sold a defective product that hurt you at work, then you may be able to file a lawsuit against this third party. The outcome of your lawsuit will be determined by the tort laws appropriate to your case. For instance, in a defective product situation, product liability rules would apply to determine if the manufacturer was at fault and should be made to pay damages.

Can I collect social security disability and workers’ compensation disability benefits?

Provided you meet the criteria for both social security disability and workers’ compensation disability benefits, you should be able to collect under both worker protection programs.

What if I need help with my workers’ compensation claim?

Many people need help with various aspects of workers’ compensation claims. You may need assistance if your employer is not filing your claim in a timely manner; if you are being denied benefits; or if your rights are otherwise being violated. A workers’ compensation attorney can assist with these and other issues related to Boston workers’ compensation. Contact The Law Offices of Jeffrey S. Glassman today to schedule a free consultation to learn how we can help.

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