How to Apply for Workers’ Compensation in Boston

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 Using 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.

Every employer in Boston is required to obtain a workers’ compensation insurance policy. This policy is designed to provide compensation to workers who are injured on the job.

In order to ensure compliance, the Massachusetts workers compensation statute uses a carrot and stick approach. An employer that purchases a workers’ compensation policy is protected from being sued by his injured workers for the work injury under the exclusivity provision of the state’s workers comp statute. On the other hand, if an employer fails to purchase workers comp, the policy lapsed, or it was cancelled (usually due to non-payment of the insurance premium) at the time of the work injury, then the injured worker can file a lawsuit against the uninsured employer and recover full tort damages including pain and suffering. Pursuant to Massachusetts General Laws Chapter 152 §66, the statute of limitations for filing a lawsuit against an uninsured employer is 20 years from the date of the work injury or from “the date when the injured worker first became aware of the causal relationship between the disability and his employment.” As a further penalty against the uninsured employer and an incentive for employers to comply with the law, the uninsured employer loses many common tort defenses such as an injured worker’s comparative negligence, assumption of the risk, or that the uninsured employer was not negligent.

To improve your chances of obtaining the benefits that you deserve, injured workers should be aware of the rules concerning applying for workers’ compensation in Boston. For further clarification about how these rules might affect your case, contact an experienced workers’ compensation lawyer right away. En Español.

Notifying Your Supervisor

As soon as an injury or illness occurs that is related to an employee’s job, they have the right to file for workers’ compensation benefits. To begin the process, they must simply notify their supervisor. This notification should be in writing. You should file an accident report and request a copy. If your company does not have an accident report or your boss or supervisor will not fill out an accident report, then document the accident by submitting a letter or email confirming the date, time and description of the accident. You need to be able to document that you reported the accident in the event that your employer tries to argue that you did not report the accident.

Once an employer receives this notice, they have seven days to notify their insurance company and the Department of Industrial Accidents about the injury under Mass. Gen. Laws ch. 152 §6.  The workers’ comp insurer has 14 days from the date that it received notice of the work injury to begin paying workers compensation benefits or deny the claim.

Steps that Can Help the Chances of a Successful Claim

While a worker in Boston must merely inform their supervisor of the incident to begin a workers’ compensation claim, there are other things he or she could do to increase their chances of receiving full benefits.

First, an employee should attend all possible doctors’ appointments. This includes seeking emergency treatment on the day of the injury as well as following up with all appointments and rehabilitation sessions. Make sure that you get a disability note from your doctor that confirms that you are disabled due to the work injury.

Second, workers should be aware of the types of benefits that are available to them. In addition to paying for all medical costs associated with the injury, a workers’ compensation benefits package may include payments for any temporary loss of workability, compensation for partial or full incapacity, or lump sum payments for any total disability. Contact a lawyer for more information about applying for workers’ compensation in Boston and how to have a successful claim.

Learn More About Applying for Boston Workers’ Compensation Benefits

Workers’ compensation benefits can provide essential income and medical care in event of a workplace injury. While almost every worker in the Commonwealth is covered by these policies, they must take proactive steps to claim these benefits.

All you need to do to start a claim is to inform your supervisor of the injury, seek medical attention and get a disability note from your doctor. The notification of the work accident to your supervisor should be in writing to memorialize the conversation. Once this is done, your employer has a legal duty to inform their insurance company of your claim. In the meantime, you should be seeking medical treatment and making yourself aware of the potential benefits available in a case.

Massachusetts law places the burden for most of the procedure in workers’ compensation cases on the employer. Still, applying for workers’ compensation in Boston requires you to let your employer know of the injury in the proper way. This is the vital first step towards collecting all the benefits that you deserve.

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.

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