What Happens If Workers’ Compensation Doesn’t Pay in Massachusetts?

In Massachusetts, workers’ compensation is a legal route available to employees and workers injured on the job. Contrary to other jurisdictions, workers’ compensation is mandatory in Massachusetts, and employers are required by law to carry the necessary insurance to cover their employees’ claims. Workers’ compensation may cover the costs of an employee’s injuries, but that employee is barred from filing a personal lawsuit against their employer, even if they have a valid case. Unfortunately, not every claim for workers’ compensation is approved, and many workers are left with no coverage and limited options.

If you are an injured employee in Massachusetts and will not be paid workers’ compensation, your fight is not over. Other options may help you recover compensation to cover your expenses while recovering from your accident and injuries. If you filed for workers’ compensation but were denied, an attorney can help you appeal that denial and hopefully achieve a different outcome. If an appeal does not work, you may be able to file a third-party lawsuit if someone other than your employer is responsible for your workplace injury. If you cannot get workers’ compensation because your employer failed to carry the necessary insurance as legally required, you may sue your employer for your damages.

If you cannot get your workers’ compensation claim approved, our Massachusetts workers’ compensation attorneys can help. It may be tempting to throw in the towel, but our team can help you fight to get the compensation you need and deserve. Set up a free legal consultation with our staff at the Law Office of John J. Sheehan. Call (617) 925-6407 to get started.

Alternatives to Workers’ Compensation in Massachusetts

One alternative to workers’ compensation, and perhaps the first option you should consider, is filing an appeal. Workers’ compensation is not guaranteed for all employees. While the system is in place to benefit injured employees, those same employees must meet certain criteria to be approved for a compensation award. In many cases, employees are denied not because they fail to meet the necessary criteria, but because they improperly filed their claim or forgot important documentation.

If your appeal is unsuccessful or you would rather explore other options, it may be possible to file a third-party lawsuit to get compensation for your injuries. A third-party lawsuit is possible when someone other than your employer is responsible for your workplace accident. For example, you might have been injured in an accident while driving a delivery vehicle because the brakes failed. If you cannot get workers’ compensation coverage, you could sue the delivery vehicle manufacturer for the faulty brakes.

Suing your employer is rarely an option for workers’ compensation cases in Massachusetts. Even if you file a claim and get denied, you are barred from suing your boss. However, if you cannot get workers’ compensation because your employer failed to carry any workers’ compensation at all, you could sue your employer to get your injuries and damages covered. Call our Boston workers’ compensation attorneys for more information.

Appealing a Denial of Your Workers’ Compensation Claims in Massachusetts

Workers’ compensation claims are denied all the time. The criteria for approval are relatively straightforward, but not all cases will meet the standards for compensation. Generally, to be compensated, you must be considered an employee. Legally, employees are defined very broadly and include most workers who are not independent contractors. Also, your accident must have occurred within the scope of your job. If your accident happened while you were off duty or engaged in activities that were not part of your job, like running errands on your lunch break, your claim might be denied.

If you are wrongfully denied, as so many people are, you can appeal that decision. The appeals process requires filling out the necessary forms and submitting information pertinent to your case to the Department of Industrial Accidents. If everything is in order, we move to the conciliation stage of your appeal, which is essentially an informal meeting to discuss your claims and hopefully reach an agreement.

If no agreement is reached, we move on to the conference stage. A more formal proceeding occurs with an administrative law judge during this stage, who will either order the insurance company to pay your claims or deny you again. If you are denied, there may be a formal hearing before an administrative law judge where formal evidence and arguments are presented.

If we are still unsuccessful, we can appeal the decision to the Industrial Accidents Revie Board. This option is usually only available if you believe the administrative law judge from your previous proceedings made a legal error. A panel of three judges will then either uphold or reverse the decision. If your appeal is unsuccessful, it may be possible to appeal your case to the Massachusetts Court of Appeal. Contact our Cambridge workers’ compensation lawyers about getting your appeal started.

Filing Third-Party Lawsuits When Workers’ Compensation Does Not Pay in Massachusetts

In some workplace accidents, the blame does not fall on the shoulders of an employer. While the accident may have happened on the job, a third party is responsible. This third party could be a company that manufactured the equipment you use at work. Keep in mind that this option may not be available to employees whose accidents were not caused by third parties.

An example of a third-party claim would be if the tool you were using as part of your job malfunctioned and injured you. A construction worker injured by a faulty power tool would not be able to sue their employer, but they might be able to sue the company that negligently manufactured the faulty power tool. In this case, if the construction worker’s claim under workers’ compensation is denied, they could choose to sue the company behind the faulty tool for compensation.

Situations where third-party claims are unavailable are those where no third party is involved. For example, in Massachusetts, a worker may recover workers’ compensation even if they are totally at fault for their own accident. However, if they are denied, they may not pursue a third-party claim because they are the party responsible for causing the accident. Contact our Malden workers’ compensation lawyers to discuss your options.

Call Our Massachusetts Workers’ Compensation Attorneys

When workers’ compensation does not pay as you need it to, you can explore other legal options to get compensation for your injuries. Our Massachusetts workers’ compensation attorneys can help. Call (617) 925-6407 to schedule a free legal consultation with the team at the Law Office of John J. Sheehan.