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Important Things To Know About Workers’ Compensation Laws

Workers’ compensation can be a confusing and bureaucratic system. Hopefully, the information below will help you feel better informed about your rights and options.

Employers Without Proper Workers’ Compensation Coverage Will Be Fined

Because carrying workers’ compensation insurance is the law, the state of Massachusetts takes a lack of insurance very seriously.

When it is discovered that an employer does not have the proper coverage, the Department of Industrial Accidents (DIA) issues an order for the company to stop work. It will also charge the business $100 per day as a fine until the company has the proper insurance. This fee starts on the day that the stop work order is issued.

Employers may also be charged with a crime if they do not carry the proper coverage. They may also be fined or sentenced to a one-year prison term. Uninsured businesses may lose their opportunity to bid on public contracts.

Employers Must Tell Workers The Name Of Their Insurer

Under Massachusetts law, employers must give the name of their workers’ compensation insurer to their workers. This is often done through a form published by the DIA known as a notice to employees. The notice must be posted in a place where workers can easily see it. If this notice is not posted, the employer may be fined $100.

State Law Governs How Medical Only Claims Must Be Reported

Medical only claims are defined by the state of Massachusetts as workers’ compensation claims for covering medical bills and that have less than five days where the employee is unable to work. Those claims must be reported to the workers’ compensation insurance company and to the DIA. The insurance company should have a specific form that employers can use.

Weekly Compensation Payments Under Massachusetts Workers’ Compensation Law

Massachusetts workers’ compensation law states that an employee is eligible for weekly payments from workers’ compensation if they are totally or partially disabled because of an injury or occupational illness and they cannot earn their full wages for five or more calendar days. It’s important to note that those five days do not have to be consecutive.

When this occurs, workers must file an employer’s first report of illness/injury/death with DIA to stay in legal compliance. This form must be filed with the DIA. The employer should keep a copy for themselves and then provide a copy to the employee.

How Workers’ Compensation Claims Are Processed And Handled

The state of Massachusetts provides an explanation of how workers’ compensation claims must be processed and handled.

If an employee is unable to earn their full wages for five or more calendar days because they were hurt on the job, suffer from an illness that was caused by their work, or died due to an on-the-job accident or illness, Form 101 is filed with the DIA.

The employer should also submit a copy of that form to their insurer. This form should be sent within seven days from the fifth day of the employee’s inability to work. Legal holidays and Sundays are not included in that timeline.

The insurer has 14 days after receipt of Form 101 to either pay benefits or notify both the employee and the DIA that they contest the claim. Workers should know that even if the insurer starts paying benefits, they have up to 180 days to stop or modify the payments as long as they provide a seven-day notice to the worker and to the DIA. After the 180 days, the insurer can stop paying or reduce the payment only for reasons mentioned in the workers’ compensation act and regulations.

 

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What Happens If A Workers’ Compensation Claim Is Denied?

If the insurer denies the claim or if they stop or reduce the payment because of the listed reasons in the workers’ compensation act, the worker can file Form 110 (employee claim form) and ask for a hearing.

However, the insurer is given a certain amount of time to look into the claim that was filed to determine whether they will pay out on a claim. Form 110 will not be accepted until 30 days after the date that the injury, illness or disability happened or if the worker receives a denial from the insurer that was sent via certified mail.

An experienced Lowell workers’ compensation lawyer can ensure your form is filed and sent out in a timely manner.

Settling Disputed Workers’ Compensation Claims

When workers’ compensation claims are disputed, the law states that the first proceeding scheduled will be an informal attempt to settle the claim. If a settlement cannot be negotiated, a conference with an administrative judge will be scheduled.

Administrative judges are the individuals who make up the Industrial Accident Board. They handle disputed workers’ compensation claims. Both the worker and the insurer must be present at the first conference. After the conference, the judge will state, through an order, whether payment should be made or denied. Despite the ruling, both sides have 14 days to appeal the decision.

If a dispute is filed, a hearing is scheduled. The same administrative judge will consider all of the evidence. What’s different during this part of the process is that the rules of evidence will apply. Witnesses may be subpoenaed. After hearing both sides, the judge will issue a written decision.

If an error, in fact, is made or if either party believes that the judge acted outside of their authority, they have 30 days to appeal to the Review Board.

The Review Board comprises six administrative judges. Three will review the hearing transcripts. They may request oral argument from the attorneys representing the parties. The Review Board may overturn the administrative judge’s decision.

If You’re Hurt On The Job, Contact An Experienced Workers’ Compensation Lawyer

While Massachusetts workers’ compensation laws are designed to help protect injured workers, insurance companies want to make a profit. It’s important that injured Massachusetts workers talk with an experienced workers’ compensation lawyer to make sure that their rights are protected and that they are treated fairly.

Contact a dedicated lawyer at the Law Office of Jeffrey A. Young for a free consultation. Let our experience work for you. Call 978-216-1152.