You are entitled to receive weekly workers’ compensation benefits so long as you are disabled. The amount of your benefits is calculated based upon your average weekly wage, including overtime, for the 13 weeks prior to the date of your injury or incapacity. Generally, it will be approximately 58% to 62% of your gross wage. Once your claim is accepted you will continue to receive a weekly check until:
You are permitted to treat with any physician of your choice. If you wish to change, you need approval from either the insurance company handling your claim or permission from the Workers’ Compensation Court. All reasonable medical expenses that are necessary to cure relieve and rehabilitate will be paid by the insurance carrier. Travel expenses to and from insurance examinations and approved vocational rehabilitation program are reimbursable. Travel to and from your medical providers are not. We are trying to change this with the General Legislature. Medication/prescriptions that are prescribed by your treating physician for your work-related injury are reimbursable. Just forward copies of the prescriptions receipts to our office and we will forward them to the carrier for re-payment to you.
Workers’ compensation is designed to compensate for lost earnings capacity, i.e., the ability to earn wages, and for medical costs, loss of use and scarring. The theory supporting the concept of workers’ compensation is to provide a quick wage replacement for the worker not found under common law remedies. Workers’ Compensation does not compensate for pain and suffering as do negligence cases.
Workers’ Compensation is the system established by the Commonwealth of Massachusetts to protect injured workers from on-the-job accidents, whether those injuries result from a physical disability or a mental disability. The Department of Industrial Accidents has several offices located in Boston, Fall River, Lawrence, Springfield and Worcester. Depending on where you live determines what regional office has jurisdiction over your workers’ compensation claim.
If you are injured on the job as a result of the acts of a person who is not your employer or co-employee, you may make entitled to file a negligence claim against that party in addition to your workers’ compensation claim. These claims, also known as “third-party claims” usually result from auto accidents, slip and falls, and products liability claims.
If you sustain a work-related injury you should report the injury immediately in writing to you boss or supervisor, even if you think that it is not worth reporting, REPORT IT. After reporting an injury, your employer’s workers’ compensation insurance carrier will contact you in a couple of days. If you have not been contacted, you or your attorney should request the name, address and contact person of the insurance carrier and report the injury yourself. Your employer’s insurance carrier has 21 days to investigate your claim and decide if they will voluntary pay your indemnity and medical benefits. If they decide to pay benefits they must send you either a Form 103 Insurer’s Notification of Payment or a Form 104 Insurer’s Notification of Denial. The former accepts liability for your claim, while the latter rejects.
If after 21 days you do not hear from your employers’ insurance carrier, you have the right to file a claim at the Department of Industrial Accidents. You can file this claim yourself, but I recommend you contact my office to file the claim on your behalf. My office never charges a fee to represent you at the conciliation, conference or hearing stage. So how do we get paid. If we are successful on your behalf, the Department of Industrial Accidents has pre-determined fees depending on how far your claim progresses. These fees are payable your employer’s workers’ compensation carrier. When we negotiate a settlement on your behalf that statute permits either a 15% or 20% fee to be deducted from the gross settlement.
At the conciliation stage a conciliator will hear and narrow the issues so that a determination can be made as to you entitlement to receive benefits. If an agreement is reached, you will receive benefits a short time thereafter. If not, your claim automatically proceeds to a conference before an Administrative Judge who will hear and decide whether you are entitled to receive benefits. If the court determines that you are, you will receive benefits within 14 days after the Conference Order enters. If the court determines that you are not entitled to receive benefits for whatever reason, we will appeal the judge’s decision and represent you though out the entire appeal process until the end.
Weekly checks are generally paid every two weeks, however sometimes they are late because of holidays, postal service, etc. If you undergo surgery as a result of your work-related injury which leaves a visible scar and/or permanent loss of use, you are entitled an additional benefits call Section 36 benefits. Generally speaking, scarring about the hands, face and neck are compensable while other scarring is not.* The amount of that benefit varies depending on the state average weekly wage at the time of your injury. Some vocational training is offered through the Office of Education and Vocational Rehabilitation.
Please understand that we can not possibly cover every area of workers compensation on this Web Page. The above information covers the most common questions that our clients ask. If you have a question that is not covered on this Web Page, PLEASE CALL AND ASK US. That’s what we’re here for. Remember, every person and claim is unique. That’s why you decided to seek legal representation. It is our job to ensure you receive all the benefits you are entitled to.
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WorkerS' Compensation, Personal Injury & Social Security
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