Employees in Malden who suffer injuries while working may not be aware they could be entitled to workers’ compensation benefits. Benefits are available to the injured worker regardless of fault as long as the work accident occurred in the course of employment. Workers’ compensation benefits pay for lost wages and medical bills related to work-related illnesses and injuries.
However, obtaining benefits can be difficult because insurers frequently deny workers’ compensation claims. To help with the process, many employees elect to work with a Malden workers’ compensation lawyer.
An experienced personal injury attorney who understands the process could provide guidance. He or she could help ensure you are following procedures correctly to increase the chances of a quick and successful outcome.
How to File a Workers’ Compensation Claim in Malden
The employer is usually the one who must file a claim for workers’ compensation benefits. However, the first action must come from the employee, because the employee needs to provide prompt and thorough notice of the injury to the employer.
An employee can provide this notice orally or in writing, but written notice is preferable as it creates a written record showing that the employee complied with the requirements. In some cases, an employer may require the employee to fill out an accident report.
After receiving notice of the injury, the employer must file a claim with the workers’ compensation insurer and the Massachusetts Department of Industrial Accidents (DIA). If the insurer denies benefits or the employer refuses to file a claim, the employee should file Form 110 with the DIA. This form should include at least one piece of evidence such as a doctor’s report or medical bill to prove the extent of the injury. An accomplished lawyer could help an injured individual file a workers’ compensation claim.
The DIA Schedules a Conciliation
After the employee files a claim for benefits, the DIA schedules a meeting referred to as a conciliation. At this meeting, the claimant, the attorney for the insurance company, and a staff member from the DIA try to reach a voluntary agreement regarding the payment of benefits.
The DIA recommends the employee seeking benefits work with a Malden workers’ compensation lawyer to provide representation at the conciliation. The department also recommends the employee bring the following:
- Medical reports
- Reports or statements that support the employee’s claims about how the accident occurred
- Unpaid medical bills
- Statements from witnesses
- Names of witnesses
If the parties are unable to reach an agreement at this meeting, the DIA will schedule a conference with an administrative judge.
Procedures Involving an Administrative Law Judge
After a conciliation, the next stage in the process is a conference with the administrative law judge. Following the conference, the administrative judge will issue a conference order. Both sides have the right to appeal this order within 14 days. If the claim involves a medical issue that is in dispute, the injured worker will be examined by an impartial physician assigned by the DIA. The impartial physician will review the medical records from both the employee and insurer, conduct a medical examination of the employee and file a written impartial report with the DIA.
If the matter is appealed, the next step is a full evidentiary hearing where the same rules of evidence apply as in a courtroom trial. Although the impartial report is prima facie evidence under Massachusetts General Laws Chapter 152 Section 11A, the administrative judge may allow a motion by one of the parties to allow additional medical evidence if the impartial report is inadequate or if the case involves issues in dispute that are medically complex. Once a hearing decision is issued, both sides have 30 days to file an appeal to the DIA Reviewing Board. Any appeals beyond that are heard in the Massachusetts Court of Appeals and, in some cases, the Massachusetts Supreme Judicial Court.
Let a Malden Worker’s Compensation Attorney Help
Injured employees in Malden may be entitled to benefits to cover medical expenses and lost wages. If an employee is considered permanently disabled, benefits may continue long term.
Because the process of obtaining benefits is complex and legal representation is recommended following denied claims, many injured workers find it helpful to consult a knowledgeable Malden worker’s compensation lawyer right at the start. To learn more about what may be available in your situation, call now.