Can I Get Workers’ Compensation for a Head Injury in Massachusetts?
Workers’ compensation is a system employed in Massachusetts that helps injured workers while they recover from work-related injuries. At its core, Workers’ compensation does two main things from the standpoint of an injured worker: (1) Pays medical bills for medical treatment related to the injuries caused by the work accident; and (2) Pays injured workers lost wage benefits while they are disabled from work due to the work accident. Workers’ compensation covers almost any kind of injury as long as the injured worker was an employee (and not an independent contractor), and as long as the injury happened while the worker was in the course of their employment. A head injury will most likely be covered, depending on the circumstances surrounding the injury. Keep reading to find out if an injured worker can get workers’ compensation benefits for a head injury from our Massachusetts worker’s compensation attorney at the Law Office of John J. Sheehan.
Types of Injuries Covered by Workers’ Compensation in Massachusetts
Workers’ compensation does not discriminate based on the type of injury suffered. Workers’ compensation may cover almost any kind of injury if the right conditions are met. This includes any kind of head injury, whether serious or minor. If your head injury keeps you home from work for a week or prevents you from working full time ever again, you may be covered.
Workers’ compensation can cover nearly all injuries, as long as they happen at work. Injuries could be grave and serious, like fractures, amputations, electrical shock injuries and burns, or they could be less severe but disabling just the same, like muscle sprains and strains. Head injuries are among the most serious injuries that a worker can suffer in a work accident. In some cases, a head injury may be life altering, especially in the case of a skull fracture and traumatic brain injury or “TBI”. Proving that your injuries resulted from a work-related accident is the key to getting your injury, including head injuries, covered by workers’ compensation. Massachusetts law spells out several specific criteria and conditions that need to be met for an injury to be covered by workers’ compensation. Get in touch with our Boston workers’ compensation lawyer for help with your work-related injury.
Types of Accidents Covered Under Workers’ Compensation in Massachusetts
For your head injury to be covered by workers’ compensation, it must have occurred in a work-related accident. Exactly how a work-related accident is defined may seem obvious at first, but if an accident occurs outside the scope of your employment, your injuries might not be covered. For example, being struck on the head while on the job may be covered by workers’ compensation. However, being struck on the head while you are on your way to work may not be covered. Accidents that happen while you are driving to work or driving home at the end of work may not be covered by workers’ comp based on the Going-And-Coming-Rule. Each case is different and there could be an exception under the facts of your accident. That’s why it’s always best to speak with an experienced attorney as soon as possible after a work accident to see if you are eligible to receive workers compensation benefits.
In order to be eligible to receive workers comp lost wage benefits, you need to have a disability note from your treating doctor that says that you are disabled from work because of the injuries that you sustained in your work accident. It is best that the doctor include the date of accident in the disability note, so that it is clear that your doctor is stating that you are disabled due to that particular work accident. Under the Massachusetts workers’ comp law, an injured worker must be disabled for more than twenty-one days in order to receive workers comp lost wage benefits for the first five days missed from work due to the work accident.
Common types of head injuries that we see in our workers comp law office include:
- Skull Fractures
- Traumatic Brain Injuries or TBI’s
- Post-Concussion Syndrome
- Post-Concussion Headache Syndrome
Probably one of the most common causes of head injuries are falls from heights, especially in the construction industry. Some of the most common causes of head injuries are falls from heights and motor vehicle accidents. Falls from heights are frequently caused by lack of personal protective equipment such as a safety harness, lifelines, safety belts and lanyards that are connected to an anchor point. Also, falls from heights may occur due to ladders and scaffolds that are not set up correctly or are defective or not maintained in good condition by the injured worker’s employer.
Your head injury is likely to be covered as long as the injury happened while you were on the job and acting within the scope of your job duties. Even a minor head injury can be covered for medical expenses if you do not miss any work. Contact our Cambridge workers’ compensation attorneys to learn more about what kind of situations are covered by workers’ compensation insurance.
How Much Workers’ Compensation Can I Get for a Head Injury in Massachusetts?
The amount of compensation you can get for a head injury will depend on a few different factors.
First, all Massachusetts workers’ compensation lost wage benefits are based on the injured workers Average Weekly Wage or AWW. That is the average amount of gross wages – including overtime, shift differentials, commissions and bonuses – that were paid to the injured worker. The Average Weekly Wage is calculated using the injured worker’s Gross Wages before taxes and other payroll deductions over the year before the accident. If the injured worker was not employed by the company for a full year before the work accident, then the Average Weekly Wage can be pro-rated over the period worked. In some cases, the Average Weekly Wage can be based on the wages for a comparable employee.
Second, the amount of workers comp lost wage benefits an injured worker can receive will depend, in large part, on how long the injured worker will be disabled from work. There are three types of workers comp lost wage benefits in Massachusetts:
- Temporary Total Incapacity Benefits
- Partial Incapacity Benefits
- Permanent and Total Incapacity Benefits
Temporary Total benefits last up to three years. Depending on whether the injured worker received the full three years of Temporary Total benefits, the injured worker could receive up to four or five years of Partial benefits. Permanent and Total benefits can last for a lifetime. Nothing is automatic or guaranteed in workers comp. An injured worker must always be able to prove that they’re still disabled from the work injury into the future based on their treating doctor’s disability note. It can get complicated really fast, however, if the workers compensation insurance company challenges the treating physician’s disability opinion using an Independent Medical Exam or, as I prefer to call it, Insurance Medical Exam saying that either the injured worker is no longer disabled or that the work accident is not the cause for the injured worker’s disability.
Third, the amount of workers comp benefits and the amount of any potential workers comp settlement will depend on whether the worker suffered a permanent injury that will disable them into the future. At that point in the case, the legal question usually is:
- Can the injured worker return to their pre-accident job? (Included in this analysis is whether the Employer can accommodate any permanent restrictions or limitations that the worker has due to the work injury.)
- If the injured worker cannot perform their pre-accident job, what jobs can they perform with their limitations from the work injuries? (Part of this analysis includes the injured worker’s age, education, work experience and any transferable skills for other forms of employment.)
- What is the injured worker’s Earning Capacity taking into consideration the restrictions from the work accident and the injured worker’s vocational profile based on the above-listed factors?
Finally, in addition to the three forms of workers comp lost wage benefits, an injured worker may receive Specific Compensation under Massachusetts General Laws Chapter 152, Section 36. There is an in-depth listing for all the various body parts that may be injured due to a work accident in Massachusetts. In order to maximize the Section 36 Benefits, an experienced Massachusetts Workers Compensation Lawyer will hire a doctor who specializes in evaluating and treating head injuries to examine the injured worker and write a narrative report that outlines each and every permanent impairment following the American Medical Association’s Guides for the evaluation of permanent impairment. Your workers’ comp lawyer can file a claim for Section 36 Benefits based on the doctor’s report and the Massachusetts Department of Industrial Accidents guide for calculating loss-of-function, scarring and disfigurement benefits.
By filing a workers compensation claim for Section 36 Benefits, your workers comp lawyer may initiate settlement negotiations with the workers comp insurance company. Depending on the amount of Section 35 Benefits, your lawyer should try to separate the Section 36 Benefits from any settlement negotiations for future lost wage benefits. It is common that there may be a difference of opinion between the injured worker’s doctor and the insurance doctor regarding the permanent impairment. Depending on the degree of differences and the amount of money being offered to settle your workers comp lost wage claim, your workers compensation lawyer and insurance lawyer may negotiate a compromised amount of money for payment of the Section 36 Benefits. Compromise is not a negative thing as long as it is reasonable. One of the benefits of settling a workers compensation claim is that: (1) the injured worker has control of the outcome and avoids the risk that the workers’ comp lost wage benefits could be reduced or terminated; and (2) the injured worker gets a lump sum of cash that can provide financial security for the future. Depending on the amount of the lump sum settlement, the injured worker could choose a Structured Settlement, which is basically an annuity that will earn more interest – tax free – than a regular bank account would earn.
A more serious injury may involve more expensive medical bills. If your head injury resulted in a trip to the hospital, your hospital bills might be covered by workers’ compensation. The amount of coverage depends on the treatment you received at the hospital. Things like x-rays and pain medication may all be covered. The more treatment you need, the more coverage you can get.
Not only that, even if your injury comes with relatively minor medical bills, you may be entitled to greater compensation if your injury prevents you from returning to work. You must miss at least five days of work, but many people are out of commission for weeks, months, or indefinitely. Workers’ compensation can make up a portion of your lost income for as long as you are out of work.
Finally, the extent of your injuries can play a role as well. A person who can return to work, but in a lesser capacity, may receive partial compensation. A person totally incapacitated may receive more money because they cannot work at all. Speak to our Malden workers’ compensation attorney to determine how much coverage you may be entitled to.
How Do I Know if Workers’ Compensation in Massachusetts Covers My Head Injury?
In Massachusetts, all employers are required by law to have workers’ compensation insurance. Workers’ compensation is typically mandatory for employees who have been injured on the job and preempts them from suing their bosses. If your employer does not carry the necessary insurance, you may be allowed to sue them for your injuries.
After you have suffered a head injury at work, you need to immediately report it to your supervisor or employer. Your employer will then begin the process of filing a workers’ compensation claim with their insurance carrier. It is ultimately not up to your employer whether your head injury is covered. Instead, the insurance company will review your case and determine if you are covered.
It is important to seek medical attention for your injury right away because you may need some proof of your injury and related expenses to be approved for workers’ compensation. If you wait a while after your injury to go to a doctor, you risk having less than accurate medical records to support your claim. Our Wakefield workers’ compensation lawyer can help you get the compensation you need to recover in peace.
Call Our Massachusetts Workers’ Compensation Attorneys Today
If you suffered a head injury at work and need compensation while you recover, speak to our Somerville workers’ compensation attorneys immediately. Call the Law Office of John J. Sheehan at (617) 977-6647 to schedule a free consultation today.