What Is Workers Comp, Really?

In my Massachusetts workers comp law practice, I run into a lot of injured workers who don’t understand workers compensation.  At its root, workers comp is a wage replacement system and medical payment system for workers injured on the job.  Workers comp provides specific but limited benefits to injured workers. Unlike a personal injury claim, worker comp does not provide compensation for pain and suffering associated with an injury. In order to be eligible to receive Massachusetts workers comp benefits, you must be injured in the course of your employment.  The injury does not have to occur on the employer’s premises.  As long as you are working at the time of the injury, you should be covered by workers comp.  In addition, you must sustain an injury that was caused by work accident or, in some cases, was caused by repetitive trauma as a result of doing repetitive work such as data entry, working with your hands etc. Following is a a basic outline of benefits provided by the Massachusetts workers compenstion law:

  • Temporary Total Benefits: 60{b49237f8d5ca1472957084597003a717119f6f1cfb4eda5a47debe9535e6b419} of average weekly wage for up to three years.
  • Partial Benefits:  60{b49237f8d5ca1472957084597003a717119f6f1cfb4eda5a47debe9535e6b419} of the difference of post-injury earning capacity from pre-injury average weekly wage for up to five years.  If an injured worker received the full three years of temporary total benefits, then partial benefits may not exceed four years.  Also, the maximum amount an injured worker can receive in partial benefits is 75{b49237f8d5ca1472957084597003a717119f6f1cfb4eda5a47debe9535e6b419} of the temporary total rate.
  • Permanent Total Benefits: Two-Thirds of the average weekly wage without time limit as long as the injured worker is permanently totally disabled caused by the work injury.
  • Specific Compensation for visible scarring or disfigurementand loss of function.
  • Medical Benefits: Medical Treatment must be approved by workers comp through a process called Utilization Review.  If denied, the medical provider must appeal the denial.  After the second denial, the employee may file a claim with the Department of Industrial Accidents seeking an Order of Payment for the denied medical treatment.  Paymnet of medical treatment is limited to “Board Rates: or such other rate agreed to by the workers comp insurance company and medical provider.

Each case is different.  In order to protect your legal right to receive workers compensation benefits after a worker injury, you should contact an experienced Massachusetts workers comp lawyer immediately.  In addition to workers comp, you may have a third-party claim if you work injury was caused by another person or company outside your employer.  Third-party claims are common, for example, in work-related car accidents and construction accidents. If you have any questions about Massachusetts workers compensation benefits or if you have been denied workers comp, please contact Attorney John Sheehan directly for a free, no obligation consultation.

Copyright © 2011 John J. Sheehan

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