Workers’ compensation in Massachusetts is designed to help workers who have been injured on the job or due to work activities. Employers must have workers’ compensation insurance to cover employee expenses related to their injuries, including lost wage payments and necessary medical care. In fact, for most employers, it is a violation of Massachusetts law to go without workers’ compensation insurance.

As a trade-off for this benefit, employees are not permitted to sue employers outside of the workers’ compensation system for their injuries. That means that employees also cannot recover for pain and suffering or mental anguish. However, they are paid significantly faster under the workers’ compensation system, which is often extremely beneficial for employees who need income while they recover from their injury.

Workers’ Compensation in Massachusetts: Agency Involvement

In Massachusetts, the Department of Industrial Accidents (DIA) deals with workers’ compensation administration and claims. DIA plays a dispute resolution role. If you have trouble getting benefits or if your employer does not have workers’ compensation insurance, then the DIA may be able to help. The DIA can answer employee questions and get you started with pursuing a claim. However, this overworked and understaffed agency often cannot provide you with the individualized attention that your situation deserves, which is why a workers’ compensation attorney is so useful.

Getting Started with the Claim Process

When you are hurt at work, it is your employer’s responsibility to report the accident to its insurance company and start the claims process. If you need to see a doctor, your employer should let its insurance company know so the insurance company can issue you an insurance card that is specifically for medical attention related to your injury. Be sure to let the doctor know that you are requesting care related to a work injury at the appointment as well.

Of course, waiting for this process may not be practical or advisable in an emergency situation. You should always obtain urgent medical care if you need it after a work accident; the insurance company can deal with paying the hospital later.

If you are unable to earn your full, regular wages for more than five days, your employer must report your injury to not only their insurance company but also to the DIA. They do this by using Form 101, Employer’s First Report of Injury/Fatality. The required five days do not have to be consecutive, and you do not have to be fully disabled for a day to “count.” The employer must give you a copy of this report within seven days of your fifth day of incapacity (not including Saturdays and Sundays).

Receiving Lost Wage Benefits

Your employer’s insurance company must start paying you lost wage benefits within 14 days of receiving Form 101. However, they can still decide not to accept your claim within 180 days after receiving Form 101. Nonetheless, they must still continue paying you lost wage benefits for this period if you are unable to work. If your benefits will stop or be reduced, they are required to notify you in writing at least seven days before the change.

While the claims’ process may seem straightforward for workers’ compensation claims in Massachusetts, the process can be complicated if the insurance company rejects your claim or if your employer does not cooperate. A workers’ compensation attorney can be a valuable asset in many situations.