If you were injured in a workplace accident, consult with an attorney who knows how to apply for workers’ compensation in Boston. The claims process can be complex, and insurance companies often avoid paying claims. An experienced personal injury attorney could stand by your side and fight for the compensation you need.
Requirements Before Filing
The Department of Industrial Accidents publishes official forms that must be used to file a workers compensation claim. DIA Form 110 – Employee Claim is used regardless of what is being claimed, whether it is for:
- Weekly workers compensation benefit checks
- Medical treatment
- Scarring or disfigurement
- Loss of function
If the claim seeks temporary total disability, partial disability, or permanent and total disability benefits, then the claim will have to be filed with a medical record or doctor’s report explaining that the injured worker suffered an injury at work and is disabled due to the work accident. In addition, the medical record and doctor’s report must address important legal issues such as the diagnosis, mechanism of injury, causation, the extent of disability, recommended treatment plan, and prognosis.
Necessary Information for Filing
To file a workers’ compensation claim with the DIA, the following information is needed:
- Type of disability
- Doctor’s recommendations regarding physical limitations or restrictions in cases of partial disability
- Body parts affected and related injuries
- Date of injury, illness, or death if a dependent is filing for survivor benefits
- Correct name of workers’ compensation insurance carrier
- Correct name of employer
- Average weekly wage
- First date missed from work
When filing a claim seeking a reinstatement of weekly workers compensation checks that were terminated, the claim usually seeks additional lost wage benefits from the date after the checks were terminated. The Form 110 and attached doctor reports must be filed with the DIA, and a copy must be mailed to the insurance company. It is best to send the copies to the insurer by certified mail so that there is proof that the insurer received it.
Insurance Response After Receiving a Claim
The insurance company has 14 days from the date they received a copy of the claim to either pay the benefits or file a Form 107 Insurer’s Notification of Denial. Once the claim is filed, the DIA schedules a meeting called Conciliation in which the injured workers’ attorney, a DIA Conciliator, and the insurance lawyer meet to discuss the claim. The Conciliator reviews the paperwork from the parties to make sure the claim can be sent to the Administrative Judge. Also, the Conciliator tries to see if the insurer will agree to pay the claim or if the parties can negotiate a compromise.
There are many reasons why a workers’ compensation lawyer may negotiate an agreement to pay workers compensation benefits at Conciliation. Such an agreement does not settle the claim; it simply resolves the dispute at the time the claim was filed. Maybe the claim is only for a closed period of time, or the supporting medical documents are so persuasive that the insurer might reverse themselves. Maybe they have new supporting documents that could allow the DIA to reconsider their position.
Difficulties Applying for Benefits
Sometimes, injured workers try to file claims themselves or hire lawyers that do not specialize in workers comp. Without an experienced workers compensation lawyer, an injured worker may be lost in the system. The DIA does publish a Massachusetts Workers’ Compensation Guide for Injured Workers that provides an overview of the process. However, a layperson who has no experience, no training, and no education in navigating the workers’ compensation system is at a disadvantage. The insurance company has lawyers, and all injured workers should be represented by an experienced workers’ compensation lawyer who knows how to apply for workers’ compensation in Boston.
Advantages of a Workers Compensation Lawyer
The most valuable resource that a workers compensation lawyer has is knowledge and experience. The lawyer knows every step of how to apply for workers’ compensation in Boston. The attorney can work to either negotiate an agreement to pay with the insurer or push the claim as quickly as possible to Conference where an Administrative Judge will hear the claim and issue a Conference Order to pay workers compensation benefits.
A workers’ compensation lawyer has access to medical experts who can review the injured worker’s medical records, analyze the medical history and work injury, and give expert medical opinions about diagnoses, present and ongoing disability, recommended treatment plan, and prognosis.
Calling a Boston Workers’ Compensation Attorney
If you were injured in a workplace accident, do not risk taking on the insurance companies by yourself. A veteran workers’ compensation attorney knows exactly how to apply for workers’ compensation in Boston, and he or she could guide you towards a favorable resolution. Call today to schedule a consultation.