Accidents at work might leave you unable to do your job for a while, and you might lose valuable income. A Workers’ Compensation claim may help you get financial compensation so you can make ends meet while you recover. If you were recently hurt on the job and are unsure of what to do, call our legal team for help now.
To be eligible for benefits, you must be an “employee” as defined by law and unable to work for at least 6 days. Report the accident to your supervisor so they can notify their insurance provider. Typically, the insurance company has about 2 weeks to review your claim and decide whether to compensate you. Many injured workers might also consider filing a personal injury case against their employer, but this is generally prohibited, barring special circumstances.
Get a free initial case review from our Workers’ Compensation attorneys by calling the Law Office of John J. Sheehan at (617) 925-6407.
Who Can File a Workers’ Compensation Claim
Not all injured workers may be eligible to file a Workers’ Compensation claim. You must meet specific legal criteria before you can file a claim, and an attorney can help you sort out all the details.
To begin, you must be an “employee” within the definition of the law. This definition is so broad that many workers are surprised to learn that they are classified as employees. Under Mass. Gen. Laws Ch. 152 § 1(4) defines the legal term “employee” to include most workers who provide services to an employer for compensation.
A select few types of workers are excluded from this definition, including real estate salespeople, professional athletes, certain people working aboard ships in interstate commerce, and others. Additionally, independent contractors are not considered employees and are typically not covered by Workers’ Compensation unless they purchase their own insurance.
The issue of independent contractors is often a point of confusion for employees and employers. You and your boss might believe you are an independent contractor, but you are actually an employee. In such a case, you should have a lawyer.
When Should You Start a Workers’ Comp Claim in Winthrop?
It is almost always best to start a Workers’ Compensation case as soon as possible. Ideally, you should report the accident to your boss immediately. However, you must meet certain legal criteria before becoming eligible for benefits.
How Long You Must Be Disabled
You must be unable to work because of your injuries for a specific period before becoming eligible for benefits. Typically, an injured employee must miss at least 5 full or partial days of work, and they become eligible for benefits on their sixth missed day.
These days do not need to be consecutive, but they should all be related to your injuries. For example, you might injure your back at work and experience recurring back pain that leaves you unable to work for a day or two at a time. Over a few months, you might miss 5 or more days of work. At that point, you are eligible for benefits.
Reporting to Your Employer
Report the accident to your employer immediately. They must submit paperwork about your accident and injuries to their insurer within a certain period.
According to the Massachusetts Department of Industrial Accidents (DIA), your employer must submit Form 101, which is the first report of an injury or fatality, to their insurer within 7 days from your fifth missed day of work. If they do not file the form within 30 days of your injury, you can report it yourself in writing to the insurance company.
When the Insurance Company Must Act
Your employer’s insurance company must respond to your case within a certain period. Typically, the insurance company has 14 days to investigate your claim and determine whether to pay benefits. If more than 14 days have passed and you still have not heard anything, ask your lawyer for help.
Can I Sue My Boss if I File a Workers’ Comp Claim in Winthrop?
Many injured employees want to consider other legal options, but this might not be possible. Under Mass. Gen. Laws Ch. 152 § 24, a Workers’ Compensation claim is the sole legal remedy for injured employees, barring special circumstances.
You may not sue your employer for personal injuries if you are eligible for Workers’ Compensation. However, you may sue if your accident happened under specific circumstances. For example, if your employer deliberately caused the accident, you may file a personal injury case.
If you want to sue your employer, speak to your attorney as soon as possible. Workers’ Compensation covers most injured employees, so most people cannot sue. However, if your case fits certain legal criteria, your attorney can help you explore your legal options.
Workers’ Compensation Benefits in Winthrop
Benefits may compensate for numerous losses related to your work accident, including lost wages, medical expenses, and compensation for specific injuries of a more permanent nature.
Medical Expenses
Your injury may require expensive medical care, and Workers’ Compensation should cover these costs. Benefits may cover reasonably necessary medical expenses, which can be helpful for individuals with severe injuries requiring extensive medical care.
If the insurance company believes that certain treatments were not reasonably necessary for your recovery, they might push back on your claim and refuse to cover them. Your attorney can help you prove to the insurance company that your medical treatment was necessary and should be covered.
Lost Income
Those who are permanently and totally unable to work may recover two-thirds of their average weekly income for as long as their disability persists.
Those who are totally unable to work but are expected to recover may receive 60% of their average. Finally, if you are partially disabled but still able to perform work to a lesser extent, you may recover 60%, but no more than 75% of the total disability rate, of the difference between your average weekly income before the accident and your current earnings for up to 260 weeks unless special conditions exist.
Those special conditions allow up to 520 weeks if it is determined or agreed upon that you have permanently lost at least 75% functioning of any bodily function or senses, or you have a permanently disabling physical condition that stops you from working. If no such determination is made, you may recover benefits for no longer than 364 weeks.
Special Injuries
Some people experience other injuries that are permanent or disfiguring, such as lost body parts or bodily functions. In such cases, injured workers may recover compensation in addition to that for lost income and medical bills. For example, if you lost an arm in the accident, you may recover compensation worth your average weekly wage multiplied by 43.
Ask Our Winthrop Workers’ Comp Attorneys to Review Your Case
Get a free initial case review from our Workers’ Compensation attorneys by calling the Law Office of John J. Sheehan at (617) 925-6407.