When you get injured at work, you cannot always get damages in a lawsuit. Lawsuits against your employer are usually barred, and there are many situations where a lawsuit would not be possible anyway. For example, if you hurt yourself by accident, who would you sue?
Workers’ Compensation pays benefits for these exact situations. Most employers throughout the Commonwealth are required to carry insurance to pay for these damages, and our lawyers can help you get your claims paid in full.
For help with your case, call the Workers’ Compensation lawyers at the Law Office of John J. Sheehan today at (617) 925-6407.
What is Workers’ Compensation?
Most people are probably familiar with the idea that if someone causes your injury, you can often sue them. There are many difficulties with suing an employer, and many work accidents are not actually the employer’s direct fault anyway.
Workers’ Compensation makes it so that, regardless of the cause of the injury, employers are responsible for covering injured workers after a work-related accident.
Employers have Workers’ Compensation insurance to cover these damages, and claims are filed through the employer with the carrier. However, if they deny your claim, the state steps in with a process handled through the Department of Industrial Accidents (DIA) to resolve disputes, put cases before administrative judges, and get workers the benefits they need.
What Does Workers’ Comp Cover?
Workers’ Compensation covers three primary areas:
Medical Expenses
Any care you need for your injury should be covered under Workers’ Compensation. These benefits can typically cover treatment from a doctor of your choice, but you may need to undergo evaluations by doctors that your employer chooses as part of the approval process.
Lost Wages
Lost wages are partially reimbursed under Workers’ Compensation. While you are not working because of a totally incapacitating injury, you can get 60% of your pay for 156 weeks. If your total incapacity turns out to be permanent, that usually gets you 66 2/3% of your wage indefinitely.
For partial incapacity where you can still work to some extent, you usually get 60% of the difference in pre- and post-injury wages, up to 75% of what you would get for total incapacity. This has time limits that depend on the findings and agreements in the case.
The base pay rate they take 60% or 66 2/3% of is your average weekly wage before the accident. There is also a maximum benefit rate set at the average wage in Massachusetts. This rate is updated every year on October 1.
Specific Injury Payment
An additional payment is made to workers with specific injuries listed in the statute. This amount equals the Commonwealth’s average weekly wage times a number set for each injury. For example, loss of an eye is multiplied by 39, and loss of your dominant hand at the wrist is multiplied by 34.
What Does Workers’ Comp Not Cover?
Workers’ Compensation famously does not cover pain and suffering. These damages are incredibly important to many injured workers, as they account for their emotional distress, the pain of an injury, and the other feelings of grief and anguish that come from a disability.
Workers’ Compensation also does not cover other expenses, such as childcare while you are in the hospital or the remaining, unreimbursed lost wages you miss out on.
However, all of these damages can potentially be claimed through a lawsuit against the at-fault party.
Can You Sue and File a Workers’ Compensation Claim?
Often, filing both a lawsuit and a Workers’ Compensation claim is best. This can potentially get you the benefits from Workers’ Compensation much faster than they would come from a lawsuit. Then, when the lawsuit goes through, it reimburses you for pain and suffering and other damages Workers’ Compensation did not cover.
Remember that you typically cannot sue an employer and you cannot sue yourself, so lawsuits are only available to employees injured at work when a third party causes the accident.
When you do sue a third party, the Workers’ Compensation carrier that already paid you may be able to get paid back from your winnings. This prevents you from being paid double for the covered damages and potentially makes it more likely insurance carriers will pay up front, knowing they can get reimbursed anyway.
You keep anything else that comes on top of the covered benefits discussed above, e.g., pain and suffering.
When Should I Call a Lawyer?
You should call a Workers’ Compensation lawyer as soon as you can after your injury. We can help guide you through the process of filing your claim, we can talk to the insurance carrier for you, and we can start collecting records and evidence to build a strong case.
When your claim is denied and we file with the DIA, we can handle hearings and conferences where a judge will decide your claim. We can also negotiate with the employer and their insurance carrier to potentially get the case settled more quickly.
Know that no case is too simple or complex for us. You may have no experience with Workers’ Compensation, and having a lawyer can mean the difference between being taken advantage of or ignored and actually getting the damages you need.
Does My Injury Qualify for Workers’ Comp?
Many people are concerned about whether they have the right type of injury to qualify. In general, the only requirement for benefits is that your injury was work-related.
This means that it happened within the scope of your employment, e.g., while you were performing work tasks. If you got hurt outside of work, on the weekend, or even during your morning/evening commute, that usually will not count. However, even an off-site injury can still be covered if you were doing your job when it happened.
Any work-related injury should get medical coverage, but you only receive wage-loss benefits if you miss more than 5 days. This means your wage-loss pay starts on the 6th day of disability. You can get the first 5 days paid if you end up out for at least 21 days.
Call Our Workers’ Compensation Attorneys in Abington Today
For help with your case, call the Workers’ Compensation lawyers at the Law Office of John J. Sheehan at (617) 925-6407.