Workers' Compensation in Massachusetts

Having an accident at work can be disruptive at best and catastrophic at the worst. Not only can the accident have a negative impact on your health, but also on your daily life, mental health, and the lives of your loved ones. Between the years of 2016 - 2017, 220 people died while at work in the state of Massachusetts. Fortunately, most accidents, while at work, do not result in death. When you are injured in an accident at work, or have become ill due to your work conditions, you are entitled to certain benefits under workers’ compensation—mandatory insurance that your employer is required to have by state law. Workers’ compensation insurance covers lost wages and medical expenses that are the result of the work-related accident.

In 2018, 69 people lost their lives while on the job in Massachusetts. The most recent data shows that 73,300 workers have been injured or become ill while at work. Of the 73,300 reported injuries, 40,200 of those injuries resulted in days away from work, injured workers having to acquire new jobs, or restrictions on the workers' ability to perform their job duties.

In Massachusetts, the industries with the highest work-related fatalities are construction, public administration, transportation, and warehousing.

• Goods Production
• Natural Resources and Mining
• Oil & Gas Extraction
• Agriculture, Forestry, Fishing, and Hunting
• Healthcare and Social Assistance
• Education and Health Services
• Leisure and Recreation Workers
• Hospitality
• Manufacturing
• Service Providers (i.e., transportation and utilities)
• Wholesale Traders (i.e., motor vehicle parts, furniture, lumber, commercial equipment, plumbing, hardware, etc.)
• Retail Traders
• Food & Beverage Sector
• Nursing and Residential care Facilities
• Automotive Repair and Maintenance
• Construction

It is always easier to prevent injuries rather than to deal with the pain and inconvenience of treating them. If you know which activities to avoid and take extra care with those activities that you must perform, you are well on your way to preventing a work injury from the start.

The list below reflects the most frequently seen work-related injuries:

• Unintentional Opioid-Related Overdoes in the Workplace
• Transportation-Related Incidents
• Slips, Falls, and Trips
• Carpel Tunnel
• Tendonitis
• Over Exertion
• Lifting Injuries
• Sprains and Fractures
• Falls
• Exposure to Toxic Chemicals
• Burns (i.e., heat and chemical)
• Cuts, Punctures, and Lacerations
• Internal Injuries
• Amputation
• Full or Partial Paralysis
• Machine Injuries and Disfigurement
• Brain Injuries
• Material Handling

If you are injured while at work, there are many benefits that you might be eligible for under Massachusetts workers’ compensation laws. These laws are set up to help an injured worker recover lost wages, out of pocket medical expenses, and to help them get back to work as soon as possible. Filing a workers’ compensation claim is the only way that you can claim compensation for a work-related injury. The workers’ compensation law prohibits you from suing your employer for a work-related injury.

You must report the injury and file a claim in order to receive these benefits. There is also a five-day waiting period after your injury before you will receive your first payment. However, if your injury or illness persists beyond 21 days, you will be eligible for back pay for those first five days that you were out of work without pay.

Lost Wages—If you are temporarily unable to work due to the work-related injury, you can receive wage compensation. This compensation includes lost wages from missed work due to the injury or illness after the first five full calendar days that you are out of work. The amount to be received will be 60% of your gross average weekly wage. The maximum weekly benefit amount is currently at $1,383.41. These benefits are available for up to three years.

If you can still work, but your injury or illness requires you to change to a lower-paying job or work fewer hours, you are also eligible to receive the lost wages you have experienced. These benefits are available to you for up to five years.

Lost wages also include any potential future earnings that you may have been able to earn when an injury has resulted in permanent partial or total disability leaving you unable to work at all. In this case, you are eligible for what is known as permanent and total incapacity benefits. It is important to note that you do not have to exhaust the temporary benefits before applying or being awarded permanent disability benefits. Permanent disability benefits haven no time limit as long as you remain disabled.

Medical Costs—Any reasonable medical costs for treatment for your illness or injury are covered for as long as medical treatment and attention are required. Medical expenses also include prescription reimbursement and travel costs to and from medical appointments.

Death Benefits—If the work-related injury or illness results in death, the surviving spouse or eligible children could receive weekly benefits. Additionally, the cost of a funeral and burial are covered by workers’ compensation insurance. The maximum is $4,000.

Permanent Loss of Function or Disfigurement—If you have lost the use of certain bodily functions or have suffered disfigurement or scarring on your neck, hands, or face, you could qualify for a one-time payment. This payment is in addition to any of the above-listed benefits and is calculated based on the location and severity of your loss or disfigurement.

Loss of Benefits—Benefits can be stopped or reduced for various reasons. Here are the six reasons that The Commonwealth of Massachusetts Department of Industrial Accidents (DIA) lists:

• A judge, arbitrator, reviewing board, or court issues a decision or order doing so;
• You have returned to work and have filed the correct paperwork with the DIA;
• If the insurance provider has a medical report from a treating physician that states that the injured worker can return to work and the position that the worker held before the accident is still available for the worker to return to;
• You have been incarcerated and charged with a misdemeanor or felony;
• You refuse to meet with the office of education and vocational rehabilitation services;
• You refuse an examination by the insurer’s registered physician.

Limits to Benefits–Workers’ compensation allows you to receive benefits without taking your employer to court. It more or less covers the actual losses that you have incurred due to your work-related injury or illness. It does NOT cover emotional pain and suffering.

There are several steps involved in properly filing a workers’ compensation claim. However, it does not have to be complicated. If you follow the steps below, you will be well on your way.

You should seek medical attention as soon as you have been injured or become aware that you are ill. Delaying medical treatment will only harm your claim later on and could also be cause for aggravating your injury or illness. Once medical professionals have treated you, your next step will be to inform your employer, in writing, of your injury. Notifying your employer usually initiates your workers’ compensation claim, as they will need to file a report with their insurance carrier.

It is mandatory for your employer to display and make available the name and contact information for their workers’ compensation insurance carrier. You should note this information in case you need it in the future. If you cannot locate this information or it is not made readily available to you, here is the DIA website where you can verify information about your employer’s workers’ compensation coverage. If you find that your employer does not have any coverage, you will need to file a claim with the Workers' Compensation Trust Fund— part of the DIA.

IMPORTANT NOTE: There is a four-year time limit, known as the statute of limitations for reporting your injury or illness. During this period of time, you must discover the connection between your injury or illness and your job and file a claim with your employer’s worker’s compensation insurance provider.

Now, as mentioned in the above section, as soon as you report your injury to your employer, they should file a claim with their insurance carrier right away. If for some reason, your employer refuses to file a report, you have heard nothing about your claim after 30 days, or your claim has been denied by your employer’s workers’ compensation insurance carrier, you will need to take additional steps.

There are two ways that you can file a claim directly with the DIA. The first is by mail and the second is in person. Both methods require that you complete Form 110-Employee Claim. To complete Form 110, you will need to make sure that you have the information in the following section available.

At the time of filing your claim, you will need to make sure that you have essential information about your injury, job, and medical treatment on hand. The list of specifics required by the DIA follows below:

• Your date of injury or illness
• The first calendar day of work you missed
• The fifth calendar day of work you missed
• The name of the workers’ compensation insurance carrier
• The exact location of your injuries and the body parts affected
• The type of benefits you want to apply for
• How long you may be out of work
• Where you first went for treatment—the name of hospital, urgent care, or doctor’s office
• The name and contact information for the doctor who is treating you

In addition to the list of items above, you will also need a copy of one of the items below. Please note that you will need ALL of the items below, later on in the process, so it is best to gather them all at the same time and keep them safe.

• Outstanding medical bills
• Any medical reports/records
• Accident reports
• Witness statements
• Witness names and contact information

Once you have completed Form 110, gathered your supporting evidence, and made three copies of everything, you are ready to submit your paperwork. One copy is to be sent to the employer’s insurance carrier, one copy sent to the DIA, and one copy for you to keep or share with your attorney.

The importance of completing every single section of the form and attaching all supporting evidence cannot be stressed enough. If you don’t to do this, your claim will be rejected. The employer’s insurance carrier can ask the DIA to reject your claim if you fail to submit all information required—even if they already have everything in their records. The DIA can also reject a claim if any information is missing, but they will send you a letter letting you know precisely what is missing and why your claim was rejected.

Once your claim is received and accepted, you will receive a notice containing a date, time, and place to meet a conciliator. The same notification you receive will also be sent to the insurance carrier and your employer. This notice should arrive within one to two weeks after you have submitted your claim.

When you are injured at work, you can feel overwhelmed. Not only are you dealing with health issues, but you have to think about the next steps involved in securing your wages, medical expenses, and even who to contact and how to go about doing it. Answers to common workers’ compensation questions can be found below:

What is workers’ compensation?

If you are injured while at work or while doing a work-related activity, you have the right to benefits under the workers’ compensation system. Workers’ compensation is mandatory insurance that your employer must carry in the event that their employees get injured while on the job or doing a work-related task.

What does workers’ compensation cover?

Worker’s compensation benefits cover all medical bills, including prescriptions and even the transportation expenses incurred traveling to and from your medical appointments. If you have been out of work for five days, you are eligible for up to 60% of your weekly pay that you lost due to the injury or illness. If you face partial or total permanent disability, you are eligible for those benefits as well. Additionally, if you have suffered the permanent loss of function of a body part or any disfigurement, you could qualify for a one-time lump sum payment. In the unfortunate event of death, spouses and children are eligible for weekly benefits and also funeral expenses of up to $4,000.

If I am an independent contractor, can I still receive workers’ compensation benefits?

Unfortunately, only employees are covered by workers’ compensation insurance. If you have been incorrectly classified as an independent contractor instead of as an employee, you should seek legal advice right away.

Do I need to file a workers’ compensation claim if I have health insurance?

Yes. Workers’ compensation insurance is designed to cover the medical costs of employees who have been injured or become ill while at work. The full cost of all medical bills and expenses are covered, and they do not require any co-pay or premiums. Workers’ compensation benefits go beyond medical bills. It also includes lost wages, loss of the use of body parts, disfigurement, and disability—health insurance does not provide these additional benefits.

Why can’t I just sue my employer for my injury or illness?

The workers’ compensation system is designed to protect employers from personal injury lawsuits brought by their employees due to injury or illness. So, if you are injured while at work or while doing a work-related activity, your only recourse is to file a workers’ compensation claim—not a personal injury lawsuit. However, if you believe that a third party is responsible for your injury or illness, you might be able to file a lawsuit against them. In this situation, you will need to seek legal advice.

How do I know if my employer has workers’ compensation coverage?

Employers are required by law to carry workers’ compensation insurance and to display or make available the name and contact information for their insurance carrier. If this information is not readily available for you, you can check their coverage here.

When should I file a claim?

The short answer is, immediately. Delaying the reporting of your injury is unwise. As soon as you are injured or discover that you have become ill due to a work-related task, you should report it to your employer—which in essence, initiates your claim.

How long do I have to file a claim?

In Massachusetts, you have four years from the date of injury to file a workers’ compensation claim. For an illness, you have four years from the date that you discover that your illness is work-related. This time limit is known as the statute of limitations, and once the time runs out, you will not be able to seek compensation for your injury or illness.

How do I file a claim?

As soon as you report your injury or illness to your employer, your employer will complete and submit a form called the Employee Claim Form 110—this reporting is what is known as the First Report of Injury. Your employer will then send the report and all supporting medical documentation to their insurance carrier. The insurance carrier will either accept or deny the claim. If your employer does not submit your claim or refuses to submit your claim, you must take further action and file a claim directly with the DIA.

What should I do if my claim is denied?

If your claim is denied by your employer’s insurance carrier, you will need to file an appeal with the DIA by filing Employee Claim Form 110. You can find this form here. It is also suggested that you obtain the advice and representation of an attorney during this appeals process.

Who pays for my attorney and legal fees?

Workers’ compensation attorneys work on a contingency basis. What this means is that they only get paid when you do. If your case goes to court and you win, then your employer will be ordered to pay all of your legal and court fees. If your employer settles, then your attorney will be paid a percentage of your settlement amount—this amount has a cap set by law.

Can I receive payment for my pain and suffering?

No. Pain and suffering are considered emotional damages and are not covered under workers’ compensation. These damages are considered punitive damages and awarded in personal injury cases.

What amount can I expect in terms of payment and for how long?

All of your reasonable medical bills and costs will be covered.

The amount of temporary benefits that you are eligible to receive depends on your average weekly wage before the injury or illness. You can receive up to 60% of your average weekly wage for up to three years.

In Massachusetts, the Executive Office of Labor and Workforce Development (EOLWD) has a partial disability maximum of 75% percent of your temporary disability amount. You can receive these benefits for up to five years.

Permanent disability allows for 2/3 of your average weekly wages for as long as you are disabled.

How long does it take to receive my first payment?

You will usually receive a notice from your employer’s insurance carrier or the DIA, either accepting or denying your claim, within two weeks from the date that your claim is filed. If your claim has been accepted, you are eligible for lost wages after you have been out of work for five days.

You can find additional questions and answers here.

If you have been injured while at work and have questions about how to file a workers’ compensation claim, which benefits you might be entitled to, or how to appeal a denied claim, contact the Jeffrey Glassman Injury Lawyers for a free and confidential consultation at (617) 777-7777.