After a work accident, you deserve to rest and focus on your recovery. Unfortunately, you may have serious financial concerns, such as how you will pay for medical bills and make up for missed time. Although most workers are covered under workers’ compensation insurance, recovering the benefits you deserve is not always easy.
If you are struggling in your negotiations with an employer or insurance company, a skilled workers’ compensation lawyer could help. Experienced attorneys understand the workers’ compensation regulations in Boston and know how to build a successful case for the insurance company. Let a workers’ comp lawyer fight for fair benefits on your behalf.
Workers’ Compensation Regulatory Bodies
Workers’ compensation regulations in Boston and throughout Massachusetts are handled publically. It is statutorily required and administered by a public agency, the Department of Industrial Accidents (DIA). The statutory requirement is found in Mass. Gen. Laws ch. 152, § 25A. All employers are required to provide workers’ compensation insurance coverage to their employees.
Workers’ compensation insurance is an insurance coverage provided mostly by private insurance companies. Larger institutions may be self-insured and often hire a third-party administrator (TPA) to administer the claims.
In the case of public employees such as municipalities, the Commonwealth of Massachusetts, and the various departments or divisions of the Commonwealth of Massachusetts, usually the workers’ compensation coverage is through the state or the municipality. It is a combination of insurance provided by private and public entities and is regulated and administered by the DIA. Federal employees are covered under federal law. They are not covered by the Massachusetts workers’ compensation system under Chapter 152.
How Disputes are Handled in Massachusetts
When there is a dispute, the dispute is adjudicated at the DIA. All workers’ compensation insurance settlements are reviewed and approved at the DIA.
DIA Administrative Judges (AJ) hear the case at a Conference and, later, at a Hearing. If the case is not resolved or settled, the administrative judge conducts an evidentiary Hearing and issues a Hearing Decision ruling on the case. Within the Department of Industrial Accidents, there is also an appellate body called the Industrial Accidents Reviewing Board that is comprised of six Administrative Law Judges (ALJ). The ALJs are the appellate judges reviewing hearing decisions issued by the administrative judges.
After the Reviewing Board level, a case could have further appellate review at the Massachusetts Appeals Court. Beyond that, the Massachusetts Supreme Judicial Court might review the case.
Workers’ Compensation Benefits
According to workers’ compensation regulations in Boston, a person who is injured at work and begins receiving workers’ compensation benefits receives medical benefits, which means his or her medical treatment is paid for by the workers’ compensation insurer. If the individual is disabled because of the work injury, he or she will receive weekly workers’ compensation lost wage benefits. The typical case is when somebody is hurt on the job, requires medical treatment, is disabled from his or her job for a period of time, then begins receiving temporary total disability benefits. These are referred to as Section 34 benefits because the section of the workers’ compensation statute that covers temporary total disability benefits is Mass. Gen. Laws ch. 152, § 34.
The temporary total disability benefits are total because the person is disabled from all forms of employment, including the job they had when they were injured, and other jobs available in the job market. They are temporary because, by statute, the benefits last for only three years. If someone, during the course of their workers’ compensation claim, receives the full three years of temporary total disability benefits, those benefits expire and automatically end, regardless of whether or not the employee is able to go back to work.
There are two other types of benefits a person can get:
- Partial disability benefits
- Permanent and total disability benefits
Partial disability benefits are available when someone is not totally disabled. Partial disability benefits are outlined in Mass. Gen. Laws ch. 152, §35. They have an earning capacity and may receive 60 percent of the difference of their pre-injury average weekly wage and whatever they are able to earn with the physical limitations from the work injury. In the worst cases, the injured worker may be permanently and totally disabled and those benefits are outlined in Mass. Gen. Laws ch. 152, § 34A.
Seeking Help from Boston Workers’ Compensation Attorney
If you were injured in a work accident, you should consider contacting a workers’ compensation lawyer as soon as possible. Because most workers are unfamiliar with workers’ compensation regulations in Boston, they may inadvertently give up their rights during talks with the insurance companies.
Recovering from a serious injury is difficult enough without added financial stress. Let an attorney handle the details of your workers’ compensation case so you can rest easy.