The In’s and Out’s of the Process

The Massachusetts Workers’ Compensation Process – An Injured Employee’s Perspective

If you find yourself in the unfortunate situation of having been injured or disabled from work, here’s a look at what you can expect as you seek recovery of workers’ compensation benefits to help you through your period of recovery, with a hopeful return to work.

The workplace injury attorneys at Kantrovitz & Associates, P.C. exclusively represent individuals injured in the course of their employment. Our Massachusetts workplace accident lawyers believe in a hands-on approach, providing individual attention to every client we represent.

Based in Boston, Massachusetts, the workplace injury lawyers at Kantrovitz & Associates, P.C. have helped injured workers across Massachusetts, including but not limitedtoBoston, Essex, Middlesex, Norfolk, Suffolk and Plymouth. We also help Rhode Island and New Hampshire residents who were hurt on the job in Massachusetts.

For a free, no obligation evaluation of your construction accident workplace injury, contact us online. You may also call us toll free at 800-367-0871.

When You Are First Injured

The date you are injured at work marks the beginning of a timeline that controls important events for purposes of obtaining workers’ compensation benefits. Thus it’s important that you promptly notify your employer about your work-related injury. You will want to do so in writing, including information about when you were injured, how the injury happened, where it occurred, what you were doing at the time, and any other pertinent information that you can offer.

It is also a good idea to seek medical attention as soon as possible, even if you are uncertain as to the severity of your injury. As with your employer, you should provide your doctor with a detailed accounting of your injury and be detailed with all body parts injured.

Employer’s Duty To File Report Of Injury

When you have been disabled due to your work-related injury for five calendar days (which do not need to be consecutive), then your employer is required by law to file a First Report of Injury form. Your employer will do so by sending the form to (1) the Department of Industrial Accident’s Office of Claims Administration; (2) the employer’s workers’ compensation insurance company; and (3) you. Your employer must do this no later than seven days after it receives notice of your qualifying injury.

Insurer’s Duty To Pay Or Deny Benefits

When the employer’s workers’ compensation insurer receives the First Report of Injury form sent by your employer, it has fourteen days in which to either pay the claim or give notice to the Department of Industrial Accidents, your employer, and you, that it will not pay. The insurer has the option of paying benefits for up to 180 days without accepting liability or responsibility for your claim; this is called the “pay without prejudice” period. At any time during the 180-day period, the insurer can decide to stop paying benefits with seven days’ notice, although it must explain the basis for its decision if it does so. This is called an insurer’s notification of termination or modification of benefits.

Please also be aware that an insurer can request that you sign an extension to the “pay without prejudice” period. This extension, if you agree to it, gives the insurance an additional 180 days to either modify or discontinue your benefits without requesting permission to do so by the Department of Industrial Accidents. Without a good reason, an injured worker should never sign one of these extensions. An insurance company will give you the impression that they are doing you a favor, but be assured that an extension generally only favors the insurance company. You are encouraged to discuss an extension request with a qualified workers compensation attorney.

Dispute Resolution

If the insurance company denies benefits, or if it does not respond to notice of your injury, you can file a claim with the Department of Industrial Accidents. This will start the Department of Industrial Accident’s dispute resolution process regarding your benefits claim.

Alternatively, if you are receiving benefits after the pay without prejudice period has ended, the workers’ compensation insurance company can request dispute resolution if it wishes to reduce or stop your benefits. This is called a Complaint to modify or discontinue weekly benefits.

The dispute resolution process is a means for either reaching an agreement between the parties about what benefits you should receive or, failing that, a method to have the benefits formally decided in administrative proceedings.

The dispute resolution process has four stages:

• Conciliation;
• Conference;
• Hearing; and
• Reviewing Board.

More information is available regarding the dispute resolution process within the workers’ compensation benefits system in Massachusetts.

Injured on the Job? Contact Our Workplace Accident Lawyers

The Massachusetts’ workers’ compensation system is designed to ensure that workers who are injured on the job receive paid medical treatment and compensation for lost wages after being fully or partly disabled for five days or more. The experienced workers’ compensation lawyers at Kantrovitz & Associates, P.C., based in Boston, Massachusetts, can help you obtain your full benefits after a workplace accident.

For a free case evaluation of your workers’ compensation claim, please contact us online or call us toll free at 800-367-0871 to speak with an experienced workers’ compensation attorney at Kantrovitz & Associates, P.C. We have more than 20 years of experience fighting for the rights of individuals injured in the course of their employment.

Our workplace injury lawyers at Kantrovitz & Associates, P.C. help injured workers across Massachusetts, including but not limited to Boston, Essex, Middlesex, Norfolk, Suffolk, Plymouth and Merrimack River. We also represent Rhode Island and New Hampshire residents whose injuries occurred in Massachusetts or who were hired in Massachusetts but who were injured out of state.