Workers’ Compensation is the main system for getting injured workers the compensation they need. It can cover medical expenses, a portion of your lost wages, and additional compensation for certain injuries. However, the system is often quite difficult to grasp, even for lawyers who do not typically work in Workers’ Compensation.
For any work-related injury, our lawyers can help you file a claim if you meet the requirements. We can help you determine what benefits you are entitled to and fight against your employer or their insurance company’s denials.
Call our Workers’ Compensation attorneys at the Law Office of John J. Sheehan today at (617) 925-6407 for a free case evaluation.
Who Qualifies for Workers’ Compensation?
Most employees in the Commonwealth qualify for Workers’ Compensation. Even so, some categories of employee and certain industries are carved out of the legal definition of “employee.”
One category excluded from coverage is independent contractors. However, the law actually assumes most workers will be employees, even if they might get paid as independent contractors. The question is a lot more fact-sensitive, and we must look at how you control your own work, whether you work under your name or a company name, and how you get paid.
Federal workers also use a different system, meaning postal employees, for example, are not covered.
There are also special rules for including student workers and options for seasonal, casual, and part-time employees to be counted or not. There are also choices for officers and directors, sole proprietors, partners, and others who operate businesses.
What Injuries Qualify for Coverage?
If you were injured in the course of your job duties, it should qualify you for Workers’ Comp. Any “work-related” injury can get coverage for medical expenses under your employer’s policy, taking care of the full cost of treatment. However, wage-loss benefits are a bit more complex.
Your injury actually has to last long enough and keep you out of work long enough to qualify you for wage-loss benefits. As long as the injury keeps you out more than 5 days, you can get paid for the 6th day and beyond. If your injury ends up keeping you from work for at least 21 days, then you get paid for the first 5 days as well.
The percentage of your average wage that you receive as benefits shifts depending on whether your injury is total or partial and whether it will keep you out permanently or temporarily.
How Do I Prove I Cannot Work?
For you to get wage-loss benefits, you have to be incapacitated and unable to work at your full capacity. You can get compensation for an injury that leaves you partially unable to work, such as if you have reduced hours. However, you need to undergo assessments to determine your incapacity.
Generally, a medical exam from a doctor chosen by your employer’s insurance carrier will determine your incapacity status. This is separate from the doctor who treats you, which you usually have the right to choose. Instead, the doctor for this exam will essentially be working for your employer.
These reviews are not particularly independent, and you can challenge their choice of physician there is a serious conflict with the chosen doctor. You can also obtain your own exams to counter any negative evidence, so talk to your Workers’ Compensation lawyer about how to prepare for these exams and what other exams you might need.
What Other Evidence Do I Need?
You will also need evidence of how you were injured to prove your claim. Many employers reject Workers’ Comp claims on the argument that the injury happened outside of work tasks or outside of business hours. Your evidence that the injury was work-related will be vital.
You can provide your own testimony, but testimony from coworkers and supervisors will also be important. If you can obtain security camera footage of the accident, that can also be essential.
Injuries can still be covered even if they did not happen at your office or typical worksite, as long as the injury was still related to your work. For example, roadside construction workers or trainers who go to multiple facilities in a day can often file claims for injuries at those sites or even for the travel between sites.
Otherwise, injuries on your lunch break or during your commute might not be covered. However, other work-related travel injuries and injuries on retreats, at conferences, and on training trips might be covered, too.
You can even potentially seek coverage for an injury during work-from-home tasks, but obtaining evidence of how this injury happened can be harder.
Types of Injuries Covered Under Workers’ Comp in Westport
There is a stereotype of associating work-related accidents with things like massive industrial accidents, construction accidents, and other serious or acute accidents. While these certainly count, other injuries are potentially more mundane or even more serious.
Lifting and Carrying Injuries
Back injuries are one of the most common causes of time loss at work, and compensation for a herniated disc or other back injury is possible. This should even cover surgical repairs when needed.
Transportation Accidents
As mentioned above, many workers are injured in auto accidents and other transportation accidents during their jobs. Car accidents can often justify Workers’ Compensation claims and third-party lawsuits against the driver, recovering additional damages beyond what Workers’ Compensation pays.
Repetitive Stress Injuries
Many injuries stem not from accidents but repetitive use. Typing, lifting, and other injuries from everyday wear on your body can also be claimed as long as work contributed to the injury.
Cancer and Other Illnesses
Some illnesses and long-term health conditions are caused by chemical exposure or other work conditions, justifying benefits for occupational diseases like cancer, asbestosis, and more.
Call Our Workers’ Compensation Lawyers in Westport Today
For your free case evaluation, call the Law Office of John J. Sheehan’s Workers’ Compensation lawyers at (617) 925-6407.