Waltham, MA Workers’ Compensation Lawyer
Workers’ Compensation is a complicated system to navigate, particularly when employees are reeling from serious workplace injuries. Our lawyers can immediately confirm your employer’s compliance with coverage mandates and start working on your case in Waltham.
Workers’ Compensation applies if you are hurt on the job in Waltham. Our attorneys do not have to prove fault in Workers’ Compensation claims, but we may have to provide evidence confirming you did not intentionally cause your injuries, like eyewitness statements. If a workplace injury has made you miss more than five days from work, lowered your earning capacity, and left you with costly medical bills, you should pursue a Workers’ Compensation claim. After identifying the benefit type you will likely qualify for, our attorneys can also calculate your likely weekly benefit amount so you know what to expect.
Call the Law Office of John J. Sheehan for help with your case from our Workers’ Compensation lawyers at (617) 925-6407.
Situations Where Workers’ Comp Applies in Waltham, MA
As an employee, particularly one working in a dangerous industry with a high rate of workplace accidents, it is important to know when Workers’ Compensation applies and will cover your injuries and when it will not.
In general, Workers’ Compensation covers any injuries sustained at work, provided the worker did not intentionally cause them or was not under the influence of drugs or alcohol. Workers’ Compensation is a no-fault system, so it does not matter whether or not your employer or anyone else was negligent in causing your injuries; your medical expenses and some of your lost wages should be covered.
Workplaces vary, and some workers are injured while performing their job duties and driving, like commercial truckers. Such injuries would also be covered by Workers’ Compensation, as would injuries suffered at a home office while working remotely, in many cases.
While major injuries are covered by Workers’ Compensation, like back or head injuries from falls, less obvious harms are also covered. For example, you can get Workers’ Compensation benefits for repetitive motion injuries and for illnesses from toxic or chemical exposure at work.
You should be covered by Workers’ Compensation on the first day of your employment, as all employers in Massachusetts need this coverage for their workers.
Checking Your Employer’s Workers’ Comp Coverage After a Workplace Injury
Despite Massachusetts requiring Workers’ Compensation policies for all companies with employees, not all employers comply with this mandate. After a workplace accident, our attorneys can immediately check your employer’s compliance and help you move forward with your pursuit of compensation, even if they do not have coverage.
Workers’ Compensation is the exclusive remedy for injured employees in Massachusetts, and they cannot sue their employers, even if those employers ignore policy requirements. However, injured employees can file a claim with the Workers’ Compensation Trust Fund established under Mass. Gen. Laws Ch. 152, § 65, which would provide the same benefits as an employer’s Workers’ Compensation carrier. To achieve this, our lawyers will show your employer’s non-compliance and provide the same evidence of your injury and damages as we would with any Workers’ Compensation claim in Waltham.
When to Pursue Workers’ Compensation in Waltham, MA
If you recently suffered an on-the-job injury, or noticed complications of an injury or illness, contact our attorneys about filing a Workers’ Compensation case. We can see if you qualify based on your injury and how many days of work you have missed so far.
You Have Missed Time from Work
Covered employees qualify for benefits once they have missed five full or partial calendar days of work because of an injury or illness. These missed days do not have to be consecutive. You have four years from the date you were injured or when you discovered an injury or illness to file your Workers’ Compensation case, according to § 41. However, if you are missing work now because of an injury, there is no benefit to delaying your case despite having time to bring it.
Your Earning Capacity Has Lowered
Workers’ Compensation is not just for those who need to take considerable time off from work after an accident. Partial incapacity benefits provide damages to workers who need to take lesser-paying jobs or positions because of a workplace injury. If your earning capacity will be affected for the foreseeable future because of an accident at work, you could be entitled to damages from your employer’s Workers’ Compensation carrier.
Keep in mind that any reduction in your ability to work and earn money should be enough to qualify you for wage-loss benefits, there is just a difference in which section of the law your benefits come under and the rate at which your benefits are paid.
You Face Costly Medical Expenses
Workers’ Compensation can cover medical expenses in full, so pursuing a claim is wise if you are struggling with hospital costs following a workplace accident. We can monitor these expenses on your behalf so that we can present your employer’s carrier with evidence of your current damages when filing your claim.
There is No Liable Third Party
Third parties are involved in some workplace accidents, giving victims someone to sue for their damages. This could yield additional compensation for some victims, such as those who can sue negligent product manufacturers for defective equipment exploding or malfunctioning. For example, a lawsuit would enable you to get damages for your pain and suffering, whereas a Workers’ Compensation claim would not. If there is a liable third party our attorneys can file a lawsuit against, we can explain the benefits of taking that route to get compensation. When that is not possible, Workers’ Compensation can cover many of the most consequential damages you have incurred, like medical bills.
Injuries that Lead to Workers’ Comp Claims in Waltham, MA
Any workplace injury that prevents an employee from working could lead to Workers’ Compensation claims, some of the most common being back and spine injuries, head and brain injuries, sprains and fractures, disfiguring injuries, and repetitive motion injuries.
Back and Spine Injuries
Back and spine injuries can be some of the most debilitating, forcing workers to take lesser-paying or less labor-intensive jobs while they heal. Many workers are unable to work at all after suffering spinal cord injuries, some of which could lead to permanent paralysis. These injuries are commonly sustained during falls. While falls from higher heights increase the risk of serious back and spine injuries, slipping and falling from standing height could also end in similar injuries for workers in Waltham.
Head and Brain Injuries
Head injuries vary dramatically. A workplace concussion would likely qualify you for temporary total incapacity benefits, as you may not be able to work at all while you recover. On the other hand, traumatic brain injuries might cause permanent damage to workers’ cognitive functions, preventing them from ever earning a livable income again.
Sprains and Fractures
Sprains and fractures can happen in any working environment, from offices to construction sites. These injuries are most common during slipping, tripping, or falling accidents. Spraining your foot or ankle at work might leave you temporarily disabled, and a displaced fracture might exacerbate your damages, entitling you to Workers’ Compensation benefits for longer.
Disfiguring Injuries
Disfiguring injuries include burns, facial injuries, and amputation. Losing a limb or suffering other significantly disfiguring injuries could yield a special one-time extra payment on top of what you get for your lost wages and medical expenses, according to § 36. These additional payments vary depending on the specific injury sustained, and our Workers’ Compensation lawyers can confirm if you are eligible for extra damages from your employer’s carrier.
Repetitive Motion Injuries
Repetitive motion injuries can significantly impact a worker’s ability to perform their normal duties. These injuries are common electricians, assembly line workers, carpenters, and even office workers who spend countless hours typing. Repetitive tasks over long periods can cause these injuries, and they qualify employees for Workers’ Compensation just like any others suffered on the job in Waltham.
Evidence Needed for Workers’ Compensation Claims in Waltham, MA
When submitting Workers’ Compensation claims, our lawyers can provide sufficient evidence to get approval, including the claimant’s medical records, eyewitness statements, and work information so benefit calculations are accurate.
Medical Evidence
Medical evidence includes records of your injuries and treatments, bills confirming their cost, and statements from treating physicians. Medical records can show your exact injury or diagnosis and describe all the necessary are you received for it. For major workplace accidents, like explosions on construction sites, falls from scaffolding, or even vehicle collisions, victims should immediately go to the hospital. Repetitive motion injuries happen over time, so identifying them and starting to document them can be more challenging. As soon as you notice an injury or illness related to your workplace duties, get the appropriate medical care.
Our attorneys will also provide the contact information for your treating physician or physicians, and statements from those professionals explaining your condition and why you cannot return to your previous role just yet.
Eyewitness Statements
Many workplace accidents occur in front of other employees who become eyewitnesses our attorneys may use to strengthen your Workers’ Compensation claim further. Eyewitnesses can confirm you did not intentionally cause your injuries, which could lead to a denial. They can also confirm that you were visibly hurt at the scene immediately after the accident in question, helping your case and chances of approval.
Tell our Workers’ Compensation lawyers about any of your peers who were nearby during the accident, as well as any managers or other workers you first reported your injury to.
Work and Wage Information
Our attorneys will also provide evidence related to your income and workplace duties. Statements from managers describing your role at work and its potentially physically intensive aspects can help us explain why you cannot return to that level of employment with your current injuries. Evidence of your wages can assert your deserved compensation for them based on your disability classification, so offering documentation of your income is also important, even though the carrier might already have this information from your employer. It helps to show that we also know your wage and can calculate and confirm your deserved recovery.
Calculating Temporary Total Incapacity Benefits from Workers’ Comp in Waltham, MA
Temporary total incapacity benefits are for workers whose injuries completely stop them from working for the time being, though their physical recovery is expected in the future. Our attorneys can confirm whether or not this is the appropriate classification for you based on your injury and, if so, calculate your likely benefit amount.
The equations to calculate temporary total incapacity benefits are laid out under § 34. Our lawyers will first find your average weekly wage (AWW) before the accident. Your weekly benefit amount will be 60% of your AWW up to the maximum weekly compensation rate, which changes annually.
Temporary total incapacity benefits can last for up to 156 weeks. However, if a claimant’s disability is lifted sooner and they are able to resume workplace duties earlier than anticipated, their Workers’ Compensation lost-wage benefits might cease.
Calculating Partial Incapacity Benefits from Workers’ Comp in Waltham, MA
As mentioned, partial incapacity benefits are for those who can work after suffering an injury but at a lesser earning capacity or level. If you are earning less because of injuries sustained on the job in Waltham, our attorneys can calculate your deserved partial incapacity benefits from Workers’ Compensation.
To do this, we will take 60% of the difference between your AWW before the injury and your AWW after the injury. Partial incapacity benefits max out at 75% of what your temporary total incapacity benefits would be if you qualified.
Generally, partial incapacity benefits last for up to 260 weeks, though there are some exceptions. For example, for workers suffering the permanent loss of 75% or more of a bodily function or sense, among other specified conditions, our attorneys may be able to keep these benefits in place for up to 520 weeks in Waltham.
Calculating Permanent and Total Incapacity Benefits from Workers’ Comp in Waltham, MA
You may qualify for permanent and total incapacity benefits from Workers’ Compensation if an injury or illness suffered on the job prevents you from ever returning to work.
Payments for permanent and total incapacity benefits are calculated by taking two-thirds of the worker’s AWW before the injury. Like other payments, they are capped at the maximum weekly compensation rate, regardless of the worker’s previous income. Permanent and total incapacity benefits last indefinitely unless a worker’s condition improves and they are able to earn a meaningful income again.
Specific Injury Benefits from Workers’ Compensation in Waltham, MA
As mentioned, Workers’ Compensation can sometimes pay additional amounts on top of what it does for lost wages and medical expenses. This happens when workers suffer certain specific injuries, ranging from vision loss to limb loss. Explicit amounts are paid for these injuries, and our lawyers can ensure you get extra funds when you deserve them.
For example, loss of vision in one eye warrants extra compensation of 39 times the current state average weekly wage (SAWW). Losing sight in both eyes can lead to extra compensation of 96 times the SAWW. The SAWW changes annually, and our lawyers can ensure updated amounts are used in your calculations. Even correctible vision loss with permanent reduction in field of vision, injured workers might get one-time payments of seven times the SAWW.
Hearing loss in one ear may get you an additional payment of 29 times the SAWW, while hearing loss in both ears may get you an additional payment of 77 times the SAWW.
Losing either leg in a workplace accident could get you an extra payment of 39 times the SAWW while losing both legs would warrant additional compensation of 96 times the SAWW. There are additional guidelines for specific injury benefits in the case of partial loss of a body member, loss of a bodily function or sense, and amputation or loss of use of the major arm or hand. Furthermore, for other cases of bodily disfigurement, Workers’ Compensation may have to pay an additional $15,000 to claimants.
Workers who are unaware they may be entitled to specific injury benefits could accept settlements from Workers’ Compensation carriers that leave out the damages they deserve. While you might be most concerned with recovering lost wages and getting medical damages paid, the extra funds you get for specific injuries could be substantial, greatly increasing your recovery, so our attorneys will review your case, medical records, and injuries to confirm if you are entitled to extra money.
Getting Medical Expenses Covered by Workers’ Compensation in Waltham, MA
Workers’ Compensation is supposed to cover all reasonable and necessary medical expenses resulting from a workplace accident, no matter the cost. When initially filing your claim, our lawyers will present evidence of all medical expenses incurred to date, as well as statements from your physicians explaining the upcoming care you will need.
Keeping track of all medical bills after an accident is vital in ensuring they get covered by Workers’ Compensation. Our attorneys can organize this information on your behalf, obtaining records showing diagnoses, test results, prescribed medications, and specific treatments. This can convince the carrier of the severity of your injury, your entitlement to lost-wage benefits, and that your medical expenses should be paid by the carrier, not by you. We will also monitor the price of all care so we can provide the carrier with an itemized list of all treatments and their cost.
Once your claim is approved, the Workers’ Compensation carrier should continue to cover all upcoming medical or hospital bills related to your injury. If any are denied, contact our attorneys, and we can explain to the carrier why they are necessary and should be covered.
Preventing and Handling Workers’ Compensation Claim Denials in Waltham, MA
While the goal is to have your Workers’ Compensation claim approved the first time, that might not happen if you do not have our lawyers prepare and file your case. Workers who file independently might accidentally leave out crucial information, giving carriers reason to deny their claims. Should that happen, we can assess the reason for the original rejection and appeal the decision on your behalf.
Preventing Denials
We can prepare Workers’ Compensation claims to avoid rejections because of our attorneys’ experience navigating these claims and getting the appropriate damages for workers. Even minor clerical errors or seemingly insignificant missing information could lead to a denial, forcing you to file an appeal. A lack of medical evidence is another common reason for rejections in Waltham, which we can avoid by including the necessary doctor notes, X-rays, lab tests, MRIs, prescription records, and other medical evidence.
Waiting to report injuries to employers can complicate claims for workers, and our attorneys can also help avoid these situations by explaining the proper post-workplace accident procedures for employees in Massachusetts, which includes prompt reporting to your employer or manager.
Handling Denials
Unfortunately, when injured employees approach Workers’ Compensation claims anticipating quick approval and forgoing help from experienced attorneys, their cases could be denied. Should this happen, you can contact our attorneys to appeal your claim after reviewing the reasons for the initial rejection.
For example, suppose the carrier rejected your claim because of a lack of medical evidence. Or maybe they are contesting that your injury happened outside of work, and that is the reason for the denial. Either way, our attorneys can ensure you get the appropriate tests to confirm your injury or condition and present updated medical evidence during the appeal. We can also provide medical records from years in the past to show you do not have a pre-existing condition. Even if you do, your doctors may be able to give statements explaining that the condition you had before the accident is totally unrelated to the injuries you sustained during the workplace accident.
Call Us for Help with Your Workers’ Comp Case in Waltham, MA
Call the Law Office of John J. Sheehan at (617) 925-6407 to discuss your case for free with our Workers’ Compensation lawyers.
