Everett, MA Workers’ Compensation Lawyer

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Workers’ Compensation can help injured workers continue to receive a paycheck while out of work because of a work-related injury. Filing through this system can also help you get your medical care coverage paid for, saving you the expense of what could potentially be thousands or even hundreds of thousands of dollars in bills.

Getting your claim accepted can sometimes be difficult, especially if your employer or their insurance company refuses to pay for expensive care. However, working with our lawyers can help increase your chances of having your claim accepted. We can also help you fight for the coverage you need if your claim is denied or your benefits are later terminated, navigating the appeals process with you.

For a free review of your claim, call the Workers’ Compensation lawyers at the Law Office of John J. Sheehan at (617) 925-6407 today.

What is Workers’ Compensation in Everett, MA?

Workers’ Compensation is a program put in place so that injured workers do not need to prove that anyone was at fault for their accident to get damages for work injuries. Workers’ Compensation is an insurance system paid for by your employer to cover you and other workers in case of injury, and it should apply to most or all workers in Massachusetts.

In the past, before Workers’ Compensation existed, injured workers would typically have to sue for an injury. This would mean taking the at-fault party to court – which might have been an employer. However, most accidents at work are caused by a coworker or the injury victim themselves, though unintentionally. In these cases, the employer would not be at fault, so you would not be able to sue them. If you caused the accident yourself, then there would be no one to sue, and you would be stuck covering injuries yourself. Furthermore, you might not be better off if a coworker with similar income and assets caused your injuries.

Instead of requiring lawsuits and fault, Workers’ Compensation sees carriers pay damages to injured victims regardless of who was at fault. One of the only exceptions to this is that Workers’ Compensation does not pay for injuries that an employee caused themselves intentionally or while under the effects of drugs or alcohol on the job.

In addition to Workers’ Compensation, injured workers can also file a lawsuit against at-fault parties who are not their employer or coworkers. Our Workers’ Compensation lawyers can help you determine if this applies to your situation, but it might give you the ability to sue vendors, customers, or passers-by who caused your workplace injury.

What Injuries Does Workers’ Compensation Cover in Everett, MA?

Workers’ Compensation covers only injuries related to your work. For example, if you were injured while horsing around during a lunch break or you were hurt on your commute home, it would not be covered. Otherwise, any injuries caused by your work tasks and duties should be paid for by your employer’s carrier.

This means covering things like injuries from lifting and carrying, falls, machinery accidents, and other acute or traumatic accidents at work. It also means covering injuries from repetitive stress and strain like carpal tunnel or the development of back problems after years of lifting at work. Even illnesses like cancer and various lung diseases from breathing in particulate (e.g., asbestosis or silicosis) can be considered work-related injuries and should be covered by Workers’ Compensation.

If you get hurt at work, do not try to resume your occupational responsibilities against your doctor’s advice. Doing so could exacerbate your injuries and lengthen your physical recovery timeline.

What Benefits Does Workers’ Compensation Pay in Everett, MA?

Workers’ Compensation pays injured workers for medical bills related to the injury as well as some of their lost wages as benefits. While all medical care should be paid for, lost wages are reimbursed only at a percentage of their normal value. That exact percentage changes depending on whether your injuries are permanent or temporary and if they are partial or total.

Total incapacity that is only temporary usually gets you 60% of your normal wage up to a state maximum. If your injuries are partial and you can still work a bit, then you can only receive up to 75% of that 60%, but the benefits can go for a longer time overall, according to Mass. Gen. Laws Ch. 152, § 35. If your injuries are both total and permanent, then you receive two-thirds of your average wage until the disability ends.

Keep in mind that benefits are not paid for very short-term injuries. You can only begin drawing Workers’ Compensation if your injury keeps you out of work for six days (the sixth day is the first day of benefits). If your injury keeps you out of work for 21 days or more, then you can get paid for those first five full or partial days of work you missed.

Keep in mind that these benefits include no money for pain and suffering or other “non-economic” damages. That said, additional amounts are given when workers sustain specific injuries listed under § 36, which include injuries like major arm amputation and permanent vision loss, among others. These payments, which might add up to thousands of dollars, are extra on top of your medical benefits and payments for lost wages, not in place of them. Many workers know they qualify for Workers’ Compensation if hurt but not that particularly severe injuries might warrant additional money in their pockets, which we can confirm when we handle claims in Massachusetts.

Navigating Key Aspects of Workers’ Compensation Claims in Everett, MA

Workers’ Compensation cases can be extremely convoluted for hurt employees, who may be unsure of what is required of them throughout the process and what their employer or the carrier needs to handle. With Workers’ Compensation being the exclusive remedy after most workplace accidents, the success of claims is paramount to workers’ being able to pay medical bills and other expenses despite being unable to work. Reporting injuries to employers right away, preparing evidence for carriers, answering carriers’ follow-up questions, and handling appeals are just some of the difficulties of claims that our Workers’ Compensation lawyers can help with.

Reporting Injury to Employer

Reporting workplace accidents to employers immediately should be a top priority for employees hurt on the job. Tell your boss that you were injured and that you cannot work. They have seven calendar days of your fifth day of disability to inform their carrier. This is done using the Employer’s First Report of Injury/Fatality (Form 101). This will start your Workers’ Compensation case, with the carrier sending you information about how your claim will proceed after getting this report. Do not delay reporting the injury to your employer, as this will delay your entire case and lead to unnecessary issues. For example, the Workers’ Compensation carrier will likely question you about why you waited to report your injury, possibly suspecting that it was because you were not hurt at work.

Preparing Evidence for Claims

Workers’ Compensation cases are the most efficient and smooth when our lawyers prepare the necessary medical evidence and other proof for claims. We can compile all reports and documentation concerning diagnostic tests, evaluations, surgeries, X-rays, MRIs, CT scans, pain management medications, and doctor notes so there is no question about the existence of your injury and how it prevents you from resuming your previous workplace responsibilities, which we will also outline for the carrier. In addition to your medical records, we will prepare treating physicians’ names and contact information for the carrier.

Other evidence we may get in preparation for your Workers’ Compensation may include statements from eyewitnesses present during the on-the-job accident, video footage from security cameras at the work site, and pictures you took at the scene right after the accident.

Answering Carrier Follow-Up Questions

Insurers sometimes request answers to follow-up questions even after claimants submit the necessary medical records and other documentation. For example, you might be asked to clarify the accident’s events and details, such as its exact location at your work site and if any witnesses were present. The insurer might be looking for inconsistencies and a reason to deny paying you benefits, and we can prepare you for this stage in the process to avoid such issues. Claimants might also face detailed questions about how their injuries or conditions physically limit them and if they have followed doctors’ advice on other matters in addition to not returning to work.

Handling Claim Denials and Appeals

When Workers’ Compensation cases are denied in Massachusetts, employees who still need benefits can appeal decisions to the Department of Industrial Accidents (DIA). We can handle appeals by filing Form 110 and other additional required materials, which can be done up to four years after you receive the notification of denial from the carrier. We will prepare copies for the DIA and the Workers’ Compensation carrier and help you handle any follow-up questions the DIA may have about your case. The next step is a conciliation, an informal meeting between you, our lawyers, the Workers’ Compensation carrier, and the DIA, part of the DIA’s dispute resolution process. This is followed by a conference with an administrative law judge, then a pre-hearing conference, a hearing, and finally an appearance before the DIA’s Reviewing Board, which is the final opportunity for hurt workers to appeal claims. Issues might be resolved much sooner in the appeals process, even during the first conciliation stage, so do not hesitate to appeal your recently denied Workers’ Compensation claim. We can review your original case and the carrier’s reason for rejecting it, using that to guide how we approach your appeal.

Other Coverage for Work Injuries in Everett, MA

You might have other private insurance that can help cover your injuries as well as the option to file for disability benefits through the government. In many cases, you can still apply for Workers’ Compensation alongside these benefits. Your other option for compensation – which we mentioned briefly above – is to sue another party for your injuries.

While Workers’ Compensation laws prevent you from suing an employer, you might be entitled to sue another third party for your injuries. It is common in workplace accidents for injury victims to try to sue the manufacturer of defective safety gear or dangerous equipment used in their workplace. Injury victims can also sue other parties for things like car accidents, which is common for injured commercial drivers. You might also be able to sue customers, vendors, and contractors.