Were you injured at work?
An “injury” that is applicable to workers’ compensation laws in Massachusetts occurs any time you are hurt at work. These injuries may range from a small cut or a sprain to a catastrophic event, or even death. If anything happens to the employee when they are at work, the injury falls under the Workers’ Compensation Act and the provisions of (Massachusetts General Law) M.G.L. c. 152.
What happens to the employee after an injury occurs?
The employee has the responsibility of informing the employer of their injury “as soon as practicable after the happening thereof.” M.G.L. c. 152 §41. This statute also bars any claim for compensation not made within four years “from the date the employee first became aware of the causal relationship between his disability and his employment.”
What is the role of the employer during a workers’ compensation claim?
Once the employer receives notice of an injury having occurred, they have seven (7) calendar days to report the injury to their workers’ compensation insurance provider. M.G.L. c. 152 §6. The employer’s Workers’ Compensation insurer will then receive notice of an injury, and the insurer has fourteen (14) days to either begin paying the employee their lost wages and medical benefits, or they may also deny the claim. M.G.L. c. 152 §7(1).
Workers’ Compensation Benefits
There are three different types of benefits injured workers may receive: medical, indemnity (or lost wage benefits), and permanent impairment (or permanent damage to the body).
Medical benefits: In short, an employee who suffers an injury at work should receive medical treatment for the injuries they receive as long as their injury or injuries were causally related to the work accident. Even if there are other factors at play, the employer/insurer will be liable as long as the work injury was “a major” contributing factor, meaning the cause of the injury that occurred at work must be more than just a trivial factor. However, one exception is for mental health injuries. In that event, the work injury does have to be the predominant cause of the injury. Medical benefits are otherwise governed by M.G.L. c. 152 §§13 and 30, shall be for “adequate and reasonable health care services,” and shall include expenses incidental to such services, including mileage reimbursement for travel.
Indemnity benefits: Indemnity, or lost wage benefits, are paid based on the employee’s average weekly wage, and depending on the severity of their disability, whether temporary, total, partial, or permanent. There are also limits on how long such benefits can be received. The following are a few rules to note:
Average Weekly Wage (AWW): An employee’s lost wage benefits are paid based upon their average weekly wage. M.G.L. c. 152 §1(1) bases this on the average of their wages for the one year—or 52-week period—leading up to their injury. If they were not employed for a full year, then the wages earned during the period of time actually worked would determine the amount.
No benefits are paid for the first 5 days that an employee is out of work with an injury. M.G.L. c. 152 §29. However, if your disability lasts more than 21 days, then the insurer does have to pay you retroactively for those first 5 days.
Temporary Total Disability (TTD): As long as the employee’s disability is total, they shall receive lost wage benefits at a rate of 60% of their AWW. These benefits are capped by the statewide average weekly wage that was in effect at the time of the injury on the high end, and by the statewide minimum on the low end. In other words, the benefits an injured worker receives cannot exceed—or be less than—the statewide maximum and minimum. The only exception is where the employee’s AWW income falls below the statewide minimum. In that case the employee will receive their actual wages. These benefits can be received for a maximum of 3 years. M.G.L. c. 152 § 34.
Temporary Partial (TPD): As long as the employee’s disability is partial, they shall receive benefits at a rate of 60% of the difference between their AWW and the amount they actually earn or are capable of earning. This applies when they can return to some form of employment, with or without accommodations, but at wages below their AWW. So, for example, if you earned $100 per week before you were injured, and you are now able to return to part-time or light duty work at a rate of $50 per week, then your benefit will be $30 per week ($100 – $50 = $50 x 60% = $30 per week). These benefits can be received for either 4 or 5 years maximum, depending on what was paid for TTD benefits.
Permanent Impairment: If your injury(ies) have caused permanent damage to your body, then you may be entitled to an award. These awards vary greatly and depend upon the body part(s) that were injured, and how the damage to them is assessed. Awards may be given for such things as limping, disfigurement (e.g., a permanently crooked finger), loss of use of a body part (e.g., permanent limitations after undergoing knee or shoulder surgery), or even scarring (but note that scarring must be “cosmetic” in nature, meaning that it must be on the hands or face only). Awards for permanent impairment are based on the statewide average weekly wage in effect at the time of the injury, and award a number of weeks of benefits at that rate.
Other workers’ compensation benefits:
Always remember to keep track of your mileage to and from any medical appointments or if you made any hospital visits related to the injury for which you are making the claim. Effective May 15, 2022, mileage is paid at a rate of $0.585 per mile.
Also be aware that the Massachusetts Dept. of Industrial Accidents maintains an Office of Education and Vocational Retraining (OEVR). Should your injury become a permanent impairment, and you are no longer able to return to your previous employment, OEVR can help retrain you for a new type of work, or simply assist you with your search for a new job. [However, OEVR is only obligated to return you to work earning as much as you were making before you were injured.]
If you need further answers to questions that pertain specifically to your case, please call to schedule a free consultation. There are no fees involved with this first step, and you will pay nothing out-of-pocket for legal representation. Whether you are looking to hire an attorney or simply have questions, Attorney Michael Levin can assess your situation right over the phone.
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