Plymouth, MA Workers’ Compensation Lawyer

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While some jobs come with certain safety risks, employers should ensure that the workplace is as safe and secure as possible to minimize risks. Even so, on-the-job injuries happen all the time, and injured workers can file for Workers’ Compensation.

Workers’ Compensation is a form of insurance that employers must carry to benefit injured workers. To be eligible for compensation, a worker’s injuries must have occurred while working, and they must be disabled for at least five working days. Potential benefits include compensation for medical costs to treat injuries and partial compensation for lost income. How long you may continue receiving benefits depends on the nature of your injuries. To submit a claim, you must first notify your employer of the accident. Then, you should contact an attorney. Remember, if you are eligible for Workers’ Compensation, you typically cannot sue your employer, barring special circumstances.

For help filing your claim, contact our Workers’ Compensation lawyers at the Law Office of John J. Sheehan and schedule a free review of your case by calling (617) 925-6407.

When Injured Employees Are Eligible for Workers’ Compensation in Plymouth, MA

Not all accidents or injuries qualify workers for Workers’ Compensation. Your case needs to meet a few criteria to be eligible for benefits. First, the accident must be work-related. Second, you must be unable to work for a certain period, usually five days.

What exactly is considered a work-related accident? This is hard to nail down, as whether an accident is work-related largely depends on the nature of the injured employee’s job. Generally, accidents that happen at your place of work while you are in furtherance of normal job duties should be sufficiently work-related.

There is a bit of a gray area where accidents occur while an employee is at their place of work, but the accident itself is not entirely related to their job. For example, accidents during a lunch break, while commuting to work, or when you are doing something unauthorized might not be sufficiently work-related.

Alternatively, some accidents happen outside the workplace but can still qualify an employee for compensation. For example, accidents while traveling can qualify for Workers’ Compensation if the claimant was traveling for work.

Next, the claimant must be disabled for at least five working days. These days do not need to be consecutive. Compensation generally begins from day six, although you might recover benefits beginning from the first day of your injury under certain circumstances.

Possible Workers’ Compensation Benefits for Injured Employees in Plymouth, MA

Workers’ Compensation benefits may include payment for reasonably necessary medical costs and a portion of your lost earnings. Your precise amount of compensation depends on your injuries and how long you are unable to work.

Medical Costs

There is no limit or cap on how much compensation is available for medical care. As long as your medical treatments were reasonably necessary for your recovery, they may be covered by Workers’ Compensation.

You might have trouble claiming certain medical costs if the insurance company believes they were not reasonably necessary. For example, cosmetic procedures to reduce or remove scarring might not be considered necessary to your recovery, and you might get some pushback if you try to claim the costs of those procedures. Even so, our Workers’ Compensation lawyers can help you argue that these procedures and others were important for your recovery and should be covered.

Other medical expenses that should be covered in your claim include reimbursement for prescription medications, physical therapy, surgeries, and any other costs related to your rehabilitation and future care. You can also claim mileage reimbursement for travel costs related to your medical appointments.

Total Incapacity Benefits

Your compensation should also cover a portion of lost wages. If you are totally incapacitated and unable to do any work while recovering, you may receive 60% of your gross average weekly income, as per Mass. Gen. Laws Ch. 152, § 34. Temporary total incapacity benefits may be paid out for up to 156 weeks.

In some instances, injured workers can recover the maximum value of their average weekly wages. The minimum amount any worker can receive is 20% of their gross average weekly wages.

Partial Incapacity Benefits

Temporary partial incapacity benefits may be paid to those who are too badly injured to continue doing their normal job but can still work in a lesser capacity. These benefits may include 75% of the temporary total incapacity benefits mentioned above and may last up to 260 weeks under § 35.

The number of weeks benefits are paid can be extended up to 520 if the workplace injuries result in loss of any bodily sense or function of 75% or more. The weekly limit can also be extended when employees develop a permanent life-threatening physical condition or occupational disease. The insurer must agree or an administrative judge must find that a claimant’s injuries qualify, otherwise, benefits can only be paid for up to 364 weeks.

Permanent Incapacity Benefits

Permanent benefits might apply in cases where an injured worker is permanently disabled and can never work again. These benefits include up to 66% of your gross average weekly income and may last indefinitely, according to § 34A. Again, these benefits can be increased to the full weekly compensation rate but not lower than the minimum 20% weekly wages rate.

A permanently injured worker can also get supplemental benefits to those above to account for increasing consumer costs. On the first of October each year, without having to apply, benefits are adjusted by a certain percentage based on changes in the U.S. Department of Labor’s most current yearly annual consumer price index or by five percent, whichever is lower, as per § 34B. However, you must be receiving benefits for at least two years before qualifying for supplemental benefits.

Specific Injury Benefits

Workers with specific injuries listed under § 36 can get their benefits increased depending on the body part injured.

For instance, employees who completely lose the use of one eye after an accident can receive 39 times their average weekly income. Lost income will be multiplied by 99 for the loss of use in both eyes.

Those who lose hearing in one ear can receive benefits equal to their average weekly wages multiplied by 29. Hearing loss in both ears is compensated by multiplying the average weekly income by 77.

Benefits will also be increased for the permanent, total loss of use or amputation of a hand, with weekly wages multiplied by 34 for injuries to the dominant hand, 29 for the nondominant hand, and 77 for both hands. Weekly wages in cases of these injuries to one leg are multiplied by 39, while injuries to both legs will increase the multiplier to 96. The amputation or permanent loss of use of either foot will be compensated with a sum equal to the average weekly income times 29, increasing to 68 for loss of both feet.

One-time payments will also be made for other specific injuries, with the insurer or reviewing board deciding what equitable and proper payment will be. Injured workers who lose the use of a sense or bodily function can receive compensation of 32 times their average weekly wages, but cannot exceed 80 times their weekly income, for each lost function or sense. Those with bodily disfigurement can receive a one-time payment up to $15,000. However, disfigurement that is entirely scar-based will not be compensated unless it was the hands, face, or neck that was disfigured.

Survivors’ Benefits

Surviving family members dependent on employees who die in workplace accidents can recover survivors’ and dependents’ benefits and burial costs. Our team can determine whether you qualify as a dependent under Workers’ Compensation law.

According to § 31, a widow or widower is entitled to receive compensation amounting to two-thirds of the deceased worker’s average weekly wages. These benefits will continue to be paid as long as the surviving spouse remains unmarried. However, if a surviving spouse decides to remarry, they will no longer be considered a dependent of the deceased worker.

Additionally, each child of the deceased under 18 years old is eligible for an extra payment of six dollars a week. There are also additional benefits available for adult children who are mentally or physically disabled and continue to rely on the surviving spouse for support.

In the event that the surviving spouse passes away or gets married again, the insurance company will shift benefits to the deceased’s children. Still, the statute prevents children of the surviving spouse from obtaining more than what the surviving spouse would have received had the marriage continued.

In any case involving the death of a worker, the employer’s insurer must pay the reasonable burial costs to surviving dependents pursuant to § 33. However, burial expense benefits cannot exceed eight times the deceased employee’s average weekly income.

Non-Medical Benefits

Some permanently injured workers can eventually return to work or get employment close to their pre-injury job with the proper vocational rehabilitation. Non-medical benefits can be recovered for necessary services related to vocational treatment, as per § 1(12). You might need training and education for a new position or modifications to your current workplace to adjust. Our team can help you claim any vocational expenses necessary to get you as close as possible to your pre-injury income.

How to Submit a Workers’ Compensation Claim After an Accident in Plymouth, MA

Your first step should be to report the accident to your employer immediately. Ideally, it would be best to inform your boss about the accident and your injuries immediately. However, this is not always what happens, as people sometimes only realize the true extent of their injuries later.

As said before, your injuries must prevent you from working for at least five non-consecutive days to be eligible for Workers’ Compensation. If you have not yet reported your accident to your boss, you have no more than 7 days after your fifth day of disability to notify your boss and begin a claim. Even if you do not think your accident was that bad, you should still report it to your employer.

Your employer should report the accident to their insurance company. Once you become eligible for compensation, the insurance company should evaluate your claims and determine whether you can receive benefits. If your boss does not report the case to the insurance company, a lawyer can help you file a claim on your own.

Can I File for Workers’ Compensation and Sue My Employer After a Plymouth, MA Accident

Generally, lawsuits against employers are barred if the injured worker is eligible for Workers’ Compensation. There is no choice, and you cannot opt out of Workers’ Compensation. If it is available, Workers’ Compensation is the sole legal remedy. However, special circumstances might permit you to sue your employer or others, and you should discuss the matter with a lawyer.

Massachusetts’s Workers’ Compensation system prohibits injured workers from suing their employers. However, you might be able to sue other liable parties. For example, if you were hurt by a defective tool you use as part of your job, you can sue the manufacturer in a product liability lawsuit.

You might sue your employer if they do not have the insurance necessary for you to file a Workers’ Compensation claim. You can also sue your employer if they deliberately caused your accident, although proving such claims can be hard. If you are interested in a lawsuit, talk to a lawyer as soon as possible.