How Workers’ Compensation Works In Massachusetts

Massachusetts State House Stock Photo

Workers’ compensation can be confusing. It is also difficult to know whether the insurance company or your employer are giving you the right information. Thankfully, if you have been injured on the job, your employer or their insurance company is not your only source of information.

You can speak with the Department of Industrial Accidents (DIA), and you can talk to a Massachusetts workers’ compensation lawyer. Both of these options will help you fully understand your rights and your employer’s obligation. An attorney can also help you determine what to do next after an accident, after your claim has been denied, or if you are having trouble getting your benefits.

Workers’ Compensation Basics in Massachusetts

Workers’ compensation is a benefits program offered to help employees as they recover from a work-related injury or illness. It provides monetary benefits and medical care. In Massachusetts, the DIA monitors this program and helps with dispute resolution. The DIA offers helpful resources to workers as they are going through a workers’ compensation claim.

Getting the Workers’ Compensation Process Started

The workers’ compensation process starts with an injury or illness. Your employer actually gets the ball rolling by notifying their insurance company of your injury and any related medical bills.

The insurance company should issue you a special insurance card that you will use for all of your hospital visits that relate to your workers’ compensation injury or illness. Using this card allows medical bills to be sent directly to the insurer, so you do not have to worry about making payments or sending the insurance company copies of your bills.

If you cannot work for five or more days, then your employer must also alert the DIA of your injury. They do this by filling out a First Report of Injury/Fatality Form (Form 101 or FROI). The five days do not have to be in a row, and any day that you are even partially disabled counts as one day for purposes of the FROI form. If, for some reason, the employer does not notify the insurance company within seven days of when you told the employer about the injury, you should report the injury to the insurance company yourself.

Once the insurer has notification, it should start sending you payments for lost wages or send you a notice of denial of your claim within 14 days of receiving the FROI. In most situations, you should start receiving payments within three or four weeks after your injury. You will not, however, be compensated for the first five days in which you were unable to work unless you are considered disabled for 21 days or more.

Contested Workers’ Compensation Claims

You may want to contest your claim if you feel your benefits are too low, if the insurance company has denied you benefits, or if the insurance company is not paying your medical bills as they should. There are specific forms that you need to fill out, and you will go through an agency-based process to get your contested claim started. Some contested cases will go to a hearing before an administrative law judge, but many claims can be resolved long before this happens.

A Massachusetts workers’ compensation lawyer can help you through the contested claims process. You don’t have to go through it alone and unsure. Contact Jim Glaser Law today at 781-689-2277 or fill out our online form to request a free case evaluation.