Can I Receive Workers’ Comp if the Accident Was My Fault in Massachusetts?

If you are injured at work, one of your first thoughts will likely be how you will cover your expenses. However, you might worry that you will not qualify for Workers’ Compensation if the accident was wholly or partially your fault.

The good news is that you can still get Workers’ Compensation even if you caused your own injuries. You can get benefits from a claim without having to prove negligence like you would in a lawsuit. However, you will want to work with our skilled team to make sure you meet the other requirements necessary to collect compensation. We can determine if your employer covers you with Workers’ Compensation insurance and help prove that your injuries were work-related. If Workers’ Compensation does not seem sufficient, we can discuss whether filing a lawsuit is an option.

Call the Law Office of John J. Sheehan at (617) 925-6407 for a free case review with our Boston Workers’ Compensation lawyers.

Can I Still Get Workers’ Compensation Benefits if I Caused My Workplace Accident in Massachusetts?

The short answer is yes. In general, most workers in Massachusetts can receive Workers’ Compensation benefits even if they were at fault for their injuries. Massachusetts’ Workers’ Compensation Act operates as a “no-fault” system, so employees are covered regardless of who caused the accident. This system allows injured workers to get benefits quickly since they do not need to provide a mountain of evidence to prove liability. It also alleviates some of the pressure on the legal system since Workers’ Compensation generally bars victims from filing a lawsuit.

While Workers’ Compensation functions under no-fault rules, you will still need to meet a few criteria to be eligible for benefits. Before you file your claim, you should have our Andover, MA Workers’ Compensation lawyers review it to ensure you meet the requirements. Working with our skilled team is the best way to get your benefits quickly with the least amount of hiccups. The following are the basic conditions for getting Workers’ Compensation in Massachusetts:

You Were Classified as a Traditional Employee

Only traditional “employees” will typically be covered by their employer’s Workers’ Compensation insurance. As per Mass. Gen. Laws Ch. 152 § 1(4), most workers in Massachusetts are considered regular employees. If you have a normal boss, supervisor, and work contract, whether written or implied, you are likely a traditional employee. In fact, only a few types of employees are not covered under the law, including real estate agents, seamen involved in foreign commerce, and professional athletes.

In most cases, determining your employment status will not be too challenging. Employers are required to place posters around the workplace detailing employees’ Workers’ Compensation rights. Thus, if you see these posters and placards around your job, your employer carries Workers’ Compensation insurance.

You will not be covered by Workers’ Compensation if you are considered an “independent contractor,” according to Ch. 149 § 148B(a). This is a more common issue today as more and more businesses designate their employees as independent contractors. This allows these employers to not have to carry Workers’ Compensation insurance and typically insulates them from lawsuits.

You will be considered an independent employee if you are relatively free from the control of the employer in an independently established business. Amazon delivery drivers and Uber drivers are common examples of employees not covered by Workers’ Compensation. If you are an independent contractor injured on the job, our lawyers can still help you recover compensation through a lawsuit.

Your Accident Was Work Related

While you do need to prove fault, you will need to show that the accident was work-related. You must be injured in the course of doing your job to get benefits. For instance, if you slipped down the stairs at work and broke your ankle or injured your hand in machinery you were using correctly, your injuries would likely be considered related to the job.

Getting into a car accident at work will also be considered work-related as long as driving is part of the job duties. In most cases, driving to and from work will not count as work-related if an accident happens during your commute.

You Did Not Intentionally Cause Your Accident

Part of showing your injuries were work-related is proving that you did not intentionally cause the accident. Some accidents happen at work because employees are horsing around or using the equipment inappropriately. If you were injured because you took a break from work to play, your employer’s Workers’ Compensation provider will fight your claim. Working with our lawyers is often the best way to ensure the provider does not use this excuse as a cover for denying your claim.

Your Employer Has Workers’ Compensation Insurance

Most employers in Massachusetts are required by law to have Workers’ Compensation insurance. However, some still do not carry it to save themselves money. Fortunately, our team can still help you file for benefits even if your employer does not have insurance. The Massachusetts Department of Industrial Accidents (DIA) allows injured workers to file claims on their own if necessary. You can mail or file your application in person, but you must also include medical bills, accident reports, witness statements, and any other relevant evidence needed to process your claim.

If you are not sure if your employer offers Workers’ Compensation insurance, you can check online here. However, applying on your own can be an incredibly challenging task. Contact our attorneys to help gather your evidence and prepare your filing so that your benefits are not delayed.

You Filed the Claim on Time

Last, you must make sure you file your Workers’ Compensation claim before the deadline passes. Fortunately, Ch. 152 § 41 provides injured workers up to four years from the date they were injured or became aware that their injuries were related to their job to file their claims.

What Should I Do if My Massachusetts Workers’ Compensation Claim is Denied?

If your employer or the insurance provider denied your claim, that does not mean the end of your case. If your benefits are denied, you can appeal your claim to the DIA. You will need to submit the evidence you have to the DIA so they can review it. Once they have, they will either send you a rejection letter stating the reasons for upholding the denial or set up a meeting to discuss your claim, which is called “conciliation.”

During conciliation, you, our lawyers, the insurance company, your employer, and their lawyers will need to meet to discuss the findings of the DIA’s investigation. If your claim has merit, the insurance company might agree to start payments then. However, we can appeal further, even going to court, if the insurance company continues to fight your claim.