Workers’ Compensation Claims Process in Massachusetts

Were you seriously hurt at work and are now confused about what you should do next? Perhaps you don’t know what your protections are. The State of Massachusetts has a workers’ compensation act that is put in place to help protect workers who are hurt, killed, or who are diagnosed with an illness because of their job. Workers’ compensation is a safety net for injured workers and their families. Most workers know that workers’ compensation exists. What they don’t know, however, is how to file claim if they need to do so and how that claim is processed.

What Workers Should Do If They Are Hurt on the Job

Workers’ Compensation Claims Process Lowell Workers' Comp LawyerBefore we talk about the workers’ compensation claims process, let’s discuss what workers should do if they’re hurt on the job. This is important because, as we mentioned above, many workers don’t know what they should do if they’re hurt. The most common reason that a workers’ compensation claim is filed is because of an on-the-job injury. Occupational illnesses and death resulting from an on-the-job injury or occupational illness are also reasons that a claim can be filed.

If you’re hurt on the job, let your manager or boss know right away. It doesn’t matter if you believe that the injury is minor. Minor injuries can get worse. If you wait, it can be difficult (and sometimes even impossible) to prove that you were hurt on the job.

Get medical attention as soon as possible. Your employer or their workers’ compensation insurer may require you to see their doctor for the first visit. After that, you may see your own doctor. Just remember to ask your doctor to file through workers’ compensation instead of through your health insurance. If you do pay out of pocket for anything, make sure that you keep proof of those payments.

Keep good notes of what happened. You’ve already learned that you should report the accident to your employer. Make sure that you keep a copy of that report or letter. If you’re asked to sign anything, even if it is just an accident report, make sure that you get a copy of it. Write down the names of anyone that witnessed what happened. Every single day, write a summary of how your symptoms are affecting you and remember to put a date with every entry when you write it. If you are a union member, make sure that you get into contact with your union rep and tell them what happened.

Talk to a workers’ compensation lawyer about your rights. While the purpose of the workers’ compensation act is to protect you, and employers are required by law to have this insurance, that doesn’t mean that the insurance company will treat you in a way that is fair or equitable. A lawyer experienced in handling the Massachusetts workers’ compensation claims process can be highly beneficial. A lawyer can explain your rights to you in regards to workers’ compensation and the FMLA.

Information Workers Need to File Their Claim

As an injured worker, there is certain information that you’ll need to file your claim. You may also need this information if your claim is denied. Keep track of:

  • The date that your injury or illness happened. If you’re a family member filing because of an on-the-job death, write down the date the injury or illness happened and the date of death.
  • The first day of work you missed and the fifth day of work you missed. These dates do not have to be consecutive.
  • The name of the insurance carrier your employer uses for workers’ compensation.
  • A list of your injuries and the parts of your body that are affected.
  • The type of benefits you believe you need.
  • The amount of time you’ll be out of work, if you know.
  • The date you first went to the doctor.
  • The name of your current treating doctor.

You’ll also want to have copies of unpaid medical bills, medical reports, accident reports, witness statements, and witness names.

The Massachusetts Workers’ Compensation Claims Process

The Massachusetts workers’ compensation claims process works a little differently when compared to filing other sorts of insurance claims. According to the State of Massachusetts, the employer must file Form 101 with the Department of Industrial Accidents and with their workers’ compensation insurance carrier. This is done within seven days after the worker is unable to earn their full wages for five or more calendar days.

When the workers’ compensation insurer receives the form, they are given 14 days to either begin paying benefits, or notify the employee as well as the DIA that they are contesting the claim. The insurance company can pay on a claim for up to 180 days and have seven days during that period to stop payment or reduce the payment just by giving notice to the worker and to the DIA. If the insurer continues to pay after the 180 day mark, they can only stop the payment for reasons listed in the workers’ compensation act and regulations.

If the payments are stopped or reduced, the worker can file Employee Claim Form 110 to request a hearing. However, this form may not be filed until after 30 days after the date of disability or denial of the claim. This gives the insurance company the time to do their investigation into the claim.

Were you or a loved one injured at work and have questions about the workers’ compensation claims process in Massachusetts? Contact us today for a free consultation. Let our experience work for you.

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