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MASSACHUSETTS GOVERNMENT
EMPLOYEE WORKERS' COMPENSATION |
HEALTHCARE WORKERS'
COMPENSATION |
UNION WORKERS' COMPENSATION
| FAQS
GENERAL PURPOSE AND DESIGN OF THE WORKERS
COMPENSATION STATUTE
Simply stated, the Massachusetts Worker’s Compensation Statute is a
“ No Fault“, wage replacement system designed to pay the injured worker
both medical benefits and lost wages during his or her period of incapacity
from work. In many cases, an injured worker is also eligible to receive
vocational retraining, if their injury at work prevents them from returning
to their previous occupation. As a “No Fault“ Statute, the injured
worker is not able to sue their employer or co-workers for the civil
negligence damages called pain and suffering. While the Workers Compensation
Statute was designed to protect interests of the injured worker and his or
her family, disputes between the injured worker, his or her employer and the
workers compensation insurer often arise, which undoubtedly make an already
difficult situation more troublesome.
WHAT ARE THE BASIC LEGAL RIGHTS OF AN INJURED WORKER INVOLVED IN AN
INDUSTRIAL OR WORK RELATED ACCIDENT?
If you have been injured at work, and are unable to earn your full wages for
five or more days, or require medical treatment as a result of an accident
at work, you become eligible to receive Workers Compensation Benefits. What
are the benefits that the injured worker is entitled to receive?
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If you are disabled from work, you are entitled to receive
60% of the gross average weekly wage you earned prior to your injury.
This would include overtime wages, bonuses, as well as wages lost from
other Employers, if you held more than one job on the date of your
injury. If your injury at work results in a total and permanent
disability, you will be eligible to receive 66.67% of your gross average
weekly wage, as well as a potential annual cost of living increase. If
your injury at work results in a partial disability, and your are unable
to earn your pre-accident wages, you may be eligible to receive a weekly
partial disability benefit. In this case, you would be entitled to
receive 60% of the difference between the wages that you earned before
and after your accident at work. You are eligible to receive a partial
disability benefit even if you are required to find a different job with
a new employer, if your present employer could not accommodate your
physical limitations.
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If your injury from work requires you to obtain medical
treatment, you have the right to treat with the doctor of your choice.
You do not have to treat with a physician assigned by your employer or
the Workers Compensation Insurer. It should be noted however, that some
employers have what is termed a “ preferred provider agreement”. If
your employer has such an agreement, this simply requires you have your
initial consultation with your employers preferred medical care
provider. After this initial consultation, you are then free to treat
with the doctor of your choice. It should also be noted that you have
the legal right to be reimbursed for all of your expenses related to
your medical treatment. This includes mileage, parking and prescriptions
associated with your medical treatment.
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If your injury at work results in a Permanent Loss Of
Function, or in certain circumstances Scarring or Bodily Disfigurement,
you may be eligible for a monetary benefit for these losses, once it has
been determined that you have reached what is termed “an end medical
result”.
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If your injury at work was as a result of the Negligence or
fault of someone other than yourself, a co-worker or your immediate
employer, you may have an additional cause of action, or a “ Third
Party Negligence” case. Examples include an automobile accident in the
course of your employment, a construction site accident when the General
Contractor or a Subcontractor was at fault, or a personal injury from a
defective or dangerous product or piece of machinery. In a Third Party
Negligence case, a civil cause of action can be filed against the
negligent party, and may entitle you to civil damages, including pain
and suffering, past, present and future lost wages, medical bills, and
payment for loss of companionship or society of your family.
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If your injury results in Total Disability for 12
consecutive months or more,( or is expected to), you may have the right
to receive Social Security Disability Benefits, in addition to the
benefits you are receiving from the Workers Compensation Insurer.
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If your injury at work results in a permanent inability to
perform the essential functions of your job, you may be entitled to
Vocational Rehabilitation, which can include job placement, retraining
or schooling, paid for by the Workers Compensation Insurer.
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If an injury at work results in the death of the of the
injured worker, benefits are payable to the surviving dependants. A
surviving spouse is entitled to receive 250 weeks of the deceased
employee’s Workers Compensation Benefits, as well as annual cost of
living increases. The surviving spouse may be entitled to continue to
receive the above mentioned Benefits beyond 250 weeks if the surviving
spouse has not remarried or is not fully self-supporting. The Workers
Compensation insurer is also obligated to pay for burial expenses that
do not exceed $4,000.00.
POTENTIAL LEGAL PROBLEMS YOU MAY HAVE WITH YOUR CASE
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The Workers Compensation Insurer has started to pay you
weekly compensation benefits and medical benefits, and you suddenly
receive a certified notification advising you that your benefits will be
terminated within seven days. You are still under active treatment with
your doctor and have not been cleared to return to work. What legal
rights do I have?
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The Workers Compensation Insurer is paying you weekly
compensation benefits within the first six months of your incapacity (
“ Pay Without Prejudice Period “), and you suddenly receive a form
in the mail from the Insurance Company requesting that you extend this
period for an additional six months. What is the legal significance of
this form ? Do I have to sign this document ? Will my compensation
benefits be terminated if I refuse to sign ? Am I guaranteed to receive
my benefits for the next six months if I do sign the document ?
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The Workers Compensation Insurer has scheduled a medical
examination with one their doctors( ‘Independent Medical Exam” ). Do
I have to attend this examination ? The Insurance Company doctor has
cleared me to return to work, but my doctor, disagrees with this medical
opinion. Am I required to follow the advise or opinion of the Insurance
Company doctor ? What will happen to my entitlement to receive benefits
if I refuse to follow the advice of the Insurance Company doctor?
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My doctor has cleared me to return to work with medical
limitations or restrictions ( for example, “ no heavy lifting, or no
repetitive bending, stooping or kneeling”); or my doctor has released
me to return to work on a part-time light duty basis. Am I legally
required to return to work ? Is my employer legally required to provide
me with a light duty or part-time job that is consistent with the
limitations specified by my doctor ? What are my legal rights if my
employer cannot accommodate my physical limitations ? Can the Workers
Compensation Insurer terminate or reduce my benefits if my employer
claims to have no light duty work available ? If my employer has no
light duty available, can I find light duty work elsewhere, and still
receive a weekly compensation benefit from the Workers Compensation
Insurer ?
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My doctor or the Insurance Company doctor has released me
to return to light duty work, and my employer claims to have no light
duty work available. Because of my injury I am unable to find light duty
work with another employer. Despite having no ability to obtain light
duty work, the Workers Compensation Insurer has terminated or reduced my
weekly compensation benefits. Can the Workers Compensation Insurer
legally terminate or reduce my benefits ? Can the Workers Compensation
Insurer force me to apply for Unemployment Benefits ? If I do receive
Unemployment Benefits, what effect does this have upon my rights to
receive Workers Compensation benefits?
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My doctor has requested that I undergo a certain course of
medical treatment or surgery, and the Workers Compensation insurer
refuses to pay for the treatment. What legal rights do I have ? The
Workers Compensation Insurer claims that my medical condition and/or
need for treatment is not related to my accident at work, and refuses to
pay for the treatment recommended by my doctor. What legal rights do I
have ?
ATTORNEYS FEES
Under the Massachusetts Worker’s Compensation Statute, the vast majority
of attorneys fees are paid by the Worker’s Compensation Insurer. If you
are required to retain an attorney to either obtain benefits the Insurer is
refusing to pay, or to defend an action of the Insurer who is attempting to
reduce or terminate your benefits, it is the legal obligation of the Insurer
to pay the attorneys legal fee. If your Workers Compensation case is
resolved by lump sum settlement, an attorney may charge a fee equal to 20%
of the gross settlement.
Call Kantrovitz & Associates today to have your
Workers Compensation situation evaluated and to preserve your rights under
the law. We can be reached at 800-367-0871 or contact us via email at info@kantrovitzlaw.com.
MASSACHUSETTS GOVERNMENT
EMPLOYEE WORKERS' COMPENSATION |
HEALTHCARE WORKERS'
COMPENSATION |
UNION WORKERS' COMPENSATION
| FAQS
PERSONAL
INJURY | AUTOMOBILE
ACCIDENTS | MEDICAL
MALPRACTICE
WORKERS
COMPENSATION | SOCIAL
SECURITY DISABILITY
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