Malden Workers’ Compensation Lawyer
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 Malden workers’ compensation 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. Call the Law Office of John J. Sheehan at (617) 925-6407.
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.
Assessing the Value of a Malden Workers’ Compensation Claim
It is important to begin weighing the factors that affect the value of a workers’ compensation claim before considering a settlement. The following factors could be significant:
- Permanent loss of function
- Past and future medical needs
- Loss of income
Without the assistance of an attorney, it could be difficult to assess the factors that affect the value of a claim. It could also be difficult to make the right decision regarding workers’ compensation settlements in Malden. For example, if you agree to a settlement for past medical costs without taking into consideration future medical costs, and the period of time throughout which you would need medical care, you may be accepting an offer that does not cover your losses.
Another factor that could clearly affect the value of a Massachusetts workers’ compensation claim is the strengths or weaknesses regarding the claim itself. If there are strong arguments against your claim, it could affect the settlement value. Having an attorney assess the details of a settlement and negotiate on your behalf could be advantageous.
Entitlement to Workers’ Comp Benefits
Victims covered by a workers’ compensation policy in Massachusetts should be able to receive the following benefits:
- Medical costs
Different types of medical treatment may be covered by a workers’ compensation policy. However, it may be difficult to receive financial recovery for pain and suffering through a workers’ compensation claim.
An employer or insurance company may make the argument that an injured individual was not working within the scope of their employment at the time of the accident. Another issue that could bar an individual from receiving workers’ compensation benefits in Malden is if they willfully or intentionally injured themselves. Finally, if an individual purposefully concealed a health condition that contributed to their injury, they may not be entitled to workers’ compensation benefits. With the help of an attorney, an injured or ill individual who was harmed within the scope of their employment may be able to combat arguments against them.
Amount of Benefits that an Injured or Ill Worker May Receive in Malden, MA
The amount of benefits you may be entitled to depends on several factors. One important factor is the degree to which you are disabled. Some individuals may be completely disabled and unable to return to work for the rest of their lives. Other individuals may suffer a temporary disability from which they may recover and return to work within a period of time. Medical records are often a source of evidence regarding the extent of your injuries and other losses of function.
You may be able to recover 60 percent of your weekly wage or 60 percent of the difference between your weekly wage and the wages that you are able to earn with a disability. There may also be a maximum for the amount of benefits that you could receive. Consultation with an attorney regarding workers’ compensation benefits could be helpful in estimating these benefits.
When Does the DIA Schedule a Conciliation for a Malden Workers’ Compensation Case?
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.
Process of Settling a Workers’ Comp Claim in Malden, MA
Upon examination of a workers’ compensation claim, negotiation may begin between the insurance company and the individual or their attorney. Many of the same topics that may be considered at a hearing could be discussed during settlement talks. A settlement conference could be the culmination of the settlement process.
At a settlement conference, a judge could make a decision regarding the details of the settlement agreement. Once a settlement becomes final, you may not be able to make changes to the agreement. For this reason, it is important to understand the value of the case and the losses that you may endure in the future as well as the past.
Let a Malden Worker’s Compensation Attorney Help Get You Benefits
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 (617) 925-6407 now.