Lynn Workers’ Compensation Lawyer
Getting compensation for injuries after a workplace accident can be confusing and complicated. While many injury cases can be resolved in court, most work injury cases in Massachusetts have to be resolved through Workers’ Compensation instead. Workers’ Compensation is available to nearly all workers, but filing a claim can be complex.
Our Lynn Workers’ Compensation attorneys can help you file your claim and deal with the internal processes at your job to make sure that your case is in the best position possible to get your injuries compensated. If your employer and their insurance company deny your Workers’ Compensation claim, our attorneys can bring the case to the state and fight to get your claim approved.
For a free case review, call the Lynn Workers’ Compensation lawyers at the Law Office of John J. Sheehan today at (617) 925-6407.
How Workers’ Compensation Works in Lynn, MA
Workers’ Compensation is an insurance system that works to get injured workers compensation after an accident. In most injury cases, you need to sue the party who was at fault for your injuries. However, many workplace accidents are just accidents, and there would be no way to hold your employer liable for your injuries. Instead, Workers’ Compensation allows you to claim damages anyway.
Fault in Workers’ Compensation Claims
As mentioned, Workers’ Compensation allows you to get payments from your employer’s insurance company without having to prove fault. This is absolutely necessary for a work injury compensation system because many accidents on a work site are just a part of the job. If you were required to file a lawsuit for compensation, there are many situations where you would not be able to prove that your employer did anything wrong to cause the accident. Alternatively, the accident might have been your own fault, and a lawsuit would deny you the ability to recover damages.
Instead, Workers’ Compensation allows injured workers to get compensation regardless of how the accident happened. As long as the accident was work-related and the worker did not intentionally cause the injuries to commit Workers’ Compensation fraud, they should be able to recover through Workers’ Compensation.
Requirements for Workers’ Compensation
For a Workers’ Compensation claim to be accepted, the injuries need to have been work-related. Injuries that happen while you are at your worksite and engaged in your work duties are usually accepted. Many illnesses that stem from working conditions, such as silicosis or asbestosis, are also accepted as a work-related illness. Similarly, cancer and other long-term illnesses can also be linked to your job, and you can file Workers’ Compensation claims for these conditions as well.
For an injury to be accepted for Workers’ Compensation, it must keep you out of work for at least 6 days. These days do not need to be consecutive, but the injury must be at least severe enough for 6 lost days of work for Workers’ Compensation to pay benefits.
Workers’ Compensation Benefits
Workers’ Compensation is meant to make up for the harm you faced at work by compensating you for lost wages and medical expenses. Workers’ Compensation pays a portion of your lost wages while you are unable to work, and it pays for the medical care needed to treat your injuries. There are, however, some limitations.
Generally speaking, Workers’ Compensation pays 66% of your lost wages. However, these damages could fluctuate depending on whether the injury is temporary or permanent and whether it is partial or total. For example, if you are totally incapacitated on a temporary basis, you will receive 60% of your wages, but if your injuries are temporary and partial, you will receive 75% of that 60%. Total, permanent disabilities usually receive 66% of your wages.
When seeking medical care, you might be limited as to what doctors you can use. Your employer and their insurance company usually choose a list of doctors that are approved for Workers’ Compensation benefits. If you choose to use a doctor outside this approved list, you might not be able to receive medical care benefits.
Additionally, emergency medical care is usually covered, so never hesitate to seek medical treatment after a work injury. Your Lynn Workers’ Compensation lawyer can follow up to help ensure that it is covered by your employer’s Workers’ Compensation insurance instead of your own out-of-pocket payments or medical benefits.
Who Pays for Workers’ Compensation Benefits in Lynn, MA?
Throughout Massachusetts, Workers’ Compensation insurance is paid for by the employer. As a worker, you should never be required to pay money for Workers’ Compensation coverage, as that is a required benefit. However, some workers are not covered by Workers’ Compensation in Massachusetts and might need to file through a federal system instead or seek compensation through alternate means.
Certain categories of people are not considered “workers,” primarily because they own the company. Because of this, certain LLC owners and partners in LLPs, as well as sole proprietors running a business, are not required to carry Workers’ Compensation insurance for themselves. Additionally, certain corporate officers are not required to have Workers’ Compensation insurance for themselves. Otherwise, most workers are required to be covered by an employer’s Workers’ Compensation insurance.
Federal workers, e.g., postal workers and federal courthouse workers, are usually covered by a federal system instead of a Workers’ Compensation system monitored and enforced by the Commonwealth of Massachusetts.
Any other workers who are not covered, as well as workers whose employers fail to get Workers’ Compensation insurance, should speak with a Lynn Workers’ Compensation lawyer about potentially suing for their injuries instead.
Reporting Your Accident to Recover Workers’ Compensation Benefits in Lynn, MA
Injured workers will not be able to recover any benefits if they do not file their claims in time. In most cases, a victim will report their injuries to their employer as soon as the accident happened or right after getting emergency medical treatment. Many workplace accidents are traumatic events and workers need help covering medical bills, so they will usually not hesitate to report the incident to their employer.
However, some work-related injuries take years to develop or a victim finds their employer never filed a claim after reporting their injuries. In certain circumstances, you might have an extended period of time to file your Workers’ Compensation claim with the state Department of Industrial Accidents (DIA).
Reporting to Your Employer
Reporting your accident to your employer should officially begin the claims process. Mass. Gen. Laws Ch. 152 § 6 requires employers to report within seven calendar days any injuries occurring during the course of work that incapacitate a worker for five or more calendar days to their insurers. It might take longer than five days to process your claim, so report your accident as soon as possible after the accident to get the process started. If you are hospitalized and having trouble making a report, our team can help file on your behalf.
After you inform your employer, they must file a “notice of injuries” with their insurer. The notice must include several key details about the incident. Specifically, it should list the full names of everyone involved, a description of the nature of the employer’s business, and relevant information about the injured party, including their age and job title. Additionally, the notice must provide a comprehensive factual account of the incident, such as detailing the date, the circumstances and potential causes of the accident, and a thorough description of the injuries victims sustained.
Medical records, employee documents, and other forms of evidence will also typically be submitted to support your claim. Keep in mind, though, that the insurance company also has the discretion to request further information to help them evaluate your claim. Our lawyers can gather these records and any that your employer’s insurer requests so that your benefits are not unduly delayed.
Reporting to the Department of Industrial Accidents
In some instances, injured workers will be required to file their own claim with the DIA to get compensation for work-related damages.
This situation often arises when an employer fails to file a notice of injury after the accident, and victims can file a claim regardless of whether it was an honest mistake or an intentional omission. Other times, workers must file their own claim because their employer does not carry the Workers’ Compensation coverage that they are required to by law.
Moreover, there are instances where an employer’s insurer wrongfully denied a claim and will not reconsider the claim on appeal or refused to extend the full range of benefits the victim is entitled to recover.
In other cases, employees get medical opinions later in life that link the type of work they did to their current ailments. This commonly happens in cases of toxic exposure and jobs involving overexertion and repetitive motions.
Fortunately, § 41 generally gives injured workers four years to file their claims with the DIA. The four-year clock either starts running on the date the claimant was injured in an accident or from the date they reasonably became aware that their damages were related to their employment. To get your claim started, you must file Form 100, which you can download here, and submit it to the DIA. Our lawyers can obtain medical records and reports to file with your claim so that it gets approved on the first review.
Documenting Your Injuries for Your Workers’ Compensation Claim in Lynn, MA
Whether your employer files or you do, you will need evidence to document that the incident was work related and the damages you sustained. Because your employer’s Workers’ Compensation insurer is providing benefits, they have the right to have you evaluated by a medical professional of their choice, which they almost certainly will. Of course, you should also document your injuries with your chosen healthcare providers. You can also gather other evidence, like photos and witness statements, which can be extremely helpful in the event your claim is challenged or denied.
Independent Medical Examinations
Under § 45, injured employees must submit to independent medical examinations typically paid for by the employer’s Workers’ Compensation provider. From time to time, a person receiving benefits must undergo other independent exams when the insurer requests them, but it must be made in writing and can only be made once per six months while the recipient is disabled.
The good news is that you can have your own doctor present at an independent medical exam. However, you must cover the costs of having your own physician there and cannot be a basis for prolonging when an exam is conducted. If you refuse to do an independent medical exam, the insurer will not approve your claim or halt any benefits you are receiving when additional requests are not acknowledged.
Other Evidence to Support Your Claim
You do not need evidence to prove negligence. Still, other documentation can help the insurer process your claim, especially when it is collected right at the scene when the incident occurred. The evidence you collect will also be vital if you need to file a lawsuit for your workplace accident.
For starters, take pictures of the accident scene if you are not too hurt. Photos of the surrounding area will provide context to your claim. You should also photograph any tool, machinery, or piece of equipment involved in the accident, which will help prove your injuries happened at work, and if you have to file a third-party lawsuit against the manufacturer of the equipment. Photos of any visible injuries will also likely improve the chances your claim is approved.
There is also a good chance that coworkers witnessed you get injured. If so, get details regarding what they saw and contact information to get their statements later. Eyewitness information will probably be in company accident reports, which our team can review if you did not speak to anyone before getting immediate care.
Call Our Workers’ Compensation Attorneys in Lynn, MA Today
Our Workers’ Compensation attorneys seek to help injured workers and their families get the compensation they need after an injury. For help, call the Law Office of John J. Sheehan today at (617) 925-6407 to get a free case review.
