Massachusetts Workers’ Compensation Guide
If you were hurt on the job in Massachusetts, workers’ compensation should cover your medical care and part of your lost wages, no matter who was at fault. But insurers deny and cut off claims every day. This guide explains how the system works and when to get help.
Who Is Covered?
Most Massachusetts employers are required to carry workers’ compensation insurance, and most employees are covered from their first day of work, including part-time and seasonal workers. Benefits are available for injuries that arise out of and in the course of employment, including sudden accidents, repetitive-stress injuries, and many occupational illnesses.
Types of Benefits
- Medical benefits. Reasonable and necessary medical treatment related to the work injury, for as long as it is needed.
- Temporary total incapacity. If you cannot work at all, generally 60% of your average weekly wage, up to the state maximum, for up to 156 weeks. Benefits are not paid for the first five calendar days unless you are out for 21 days or more.
- Partial incapacity. If you can work but earn less, generally up to 75% of your temporary total rate, for up to 260 weeks.
- Permanent and total incapacity. If you are permanently unable to work, generally two-thirds of your average weekly wage, with cost-of-living adjustments, for as long as the incapacity lasts.
- Loss of function and disfigurement. A one-time payment for permanent loss of bodily function or scarring.
- Death benefits. Weekly benefits for surviving dependents and up to $4,000 for burial expenses.
How to File a Claim
- Report the injury to your employer in writing as soon as possible.
- Get medical care and tell the provider the injury happened at work.
- Your employer must report injuries that cause five or more days of lost time to its insurer and the Department of Industrial Accidents (DIA).
- The insurer must then pay, or deny the claim, within a set period.
If Your Claim Is Denied or Stopped
Disputed claims go through the Department of Industrial Accidents. The process usually starts with a conciliation, an informal meeting to try to resolve the dispute. If it does not settle, the case moves to a conference before an administrative judge, who issues an order. Either side can appeal to a full evidentiary hearing, and after that to the Reviewing Board. Medical evidence, including an impartial medical examination at the hearing stage, is often decisive.
Attorney’s Fees
In Massachusetts, when an injured worker wins at certain stages of a disputed workers’ compensation case, the insurer is generally required to pay the worker’s attorney’s fee set by statute. Fees on lump-sum settlements are also regulated by law. We will explain how fees work in your case at the start.
Third-Party Claims
Workers’ compensation usually prevents you from suing your employer, but if someone other than your employer caused your injury, such as a negligent driver, a property owner, a subcontractor on a construction site, or the manufacturer of defective equipment, you may have a separate personal injury claim against that party. A third-party claim can recover damages that workers’ comp does not pay, including pain and suffering.
Common Mistakes to Avoid
- Waiting to report the injury
- Not telling your doctor the injury is work-related
- Signing documents from the insurer without advice
- Missing appointments or independent medical examinations
- Returning to work beyond your restrictions
Learn more about our workers’ compensation practice.
Talk to a Lawyer Today
Call Muggeo & Associates at (978) 741-1177, available 24 hours a day, 7 days a week, or send us a message. Our office is at 133 Washington Street in downtown Salem.
This page provides general information only and is not legal advice. Laws and deadlines change and depend on the facts of each case. Contacting the firm does not create an attorney-client relationship. Prior results do not guarantee a similar outcome.