According to the Department of Labor, nearly $80 million in compensation and medical bills have been paid out to Massachusetts workers injured on the job – in just the first 11 months of 2016! But the process submitting a claim & getting paid can be very confusing. There are strange terms like “payment without prejudice;” Is that a good or bad thing? That’s why we’re committing this blog post to learning about workers’ compensation without prejudice, what it means for you, and how an attorney can help.
Workers’ Compensation Claims
Workers’ comp claims are never easy. When you’re hurt on the job all you want is to get your bills paid so you can get back on your feet and regain control of your life. Unfortunately, all too often a number of agencies, your employer, and their insurer will fight your claim. When you file a workers’ compensation claim in Massachusetts, you’re entitled to a certain period where your injury won’t be questioned, and that’s where this term “without prejudice” comes into play.
Workers’ Compensation without Prejudice
The period of the first 180 days after you’re injured in Massachusetts is a “pay without prejudice” period. During this time, the insurer will pay benefits without actually having to rule on your case. It does not mean that your injury has been approved for workers’ compensation benefits, nor that your employer or the insurer is willing to accept liability for your injury.
Here’s the downside of this period: at any time during this 180 days, the insurer can simply stop making payments to you, or reduce the amount you receive, by simply giving you a written notice of seven days. This is formally known as Form 106, or the “Insurer’s Notification of Termination or Modification of Weekly Compensation During Payment-Without-Prejudice Period.”
Termination or Extension of Benefits
If the insurer opts to issue Form 106 during this period, they are required to give you the full reasons they are taking such an action. Now for the good news: if the insurer chooses after this period to continue paying benefits, they are then required to continue paying benefits unless either you or a judge give them permission to reduce or stop them.
In some cases, the insurer might contact you to request extension of that initial period. This requires you to give them written consent by filing Form 105, an “Agreement to Extend 180 Day Payment Without Prejudice Period.”
How Long before Checks Arrive?
Generally speaking, you should start getting checks for benefits within 3 or 4 weeks of your accident or injury. These checks will cover lost wages after the first five calendar (not work) days you are out of work. Workers in Massachusetts do not get compensation for the first five days, unless they are disabled for at least three weeks.
What If My Claim Is Denied?
Unfortunately, it’s not unusual for a work-related disability claim to be denied following the workers’ compensation without prejudice period. When this happens, it’s not the end of the world. You do have options and you can challenge a denial claim. Doing so, requires experienced and knowledgeable representation. You will need to present specific evidence backing up your injury and need for benefits, as well as demonstrating that it occurred in the course of employment.
The best way to do this is with the help of a Massachusetts workers’ compensation attorney. If you find yourself in this situation, John J. Sheehan can help. Read about our firm, and get in touch with us for a case evaluation today!