Workers’ Compensation Questions Answered

Q: After I am injured on the job how long does the insurance company have to start sending me my check?
A: When you have been unable to earn full wages for five or more days due to an injury on the job, your employer has seven days, not including Sundays and legal holidays, to report the injury to its insurance company. The insurance company then has 14 days from receipt of the first report of injury to mail you a check or, if it intends to contest the claim, to send you a form stating its reasons for denying compensation. An employee claim form may be filed with the insurance company at any time, but the DIA cannot accept it until at least 30 days have passed since your first date of disability.

Q: I Don’t know the name of my employer’s workers’ compensation insurance company, what do I do?
A: Ask your employer. They are required by law to have a notice posted somewhere in the workplace, providing you with that information. Also, if you have been injured, and have been unable to earn full wages for five or more days, your employer must report your injury to their insurance company and to the DIA. They are required to give you a copy of this report, which contains the name and address of the insurer. If you have tried to get this information from your employer and failed, the Office of Insurance in Boston can assist you.

Q: The insurance company sent me a notice about having their doctor examine me. Do I have to go? Do they have to reimburse me for lost wages?
A: Yes, you have to submit to reasonable requests for examination by the insurance company’s doctor. However, these examinations must be at ‘reasonable’ intervals for each particular injury claimed. And the insurer must reimburse you for reasonable travel expenses.

Q: I was hurt at work and my employer does not have workers’ compensation insurance. Can I sue him? Is there a fund to pay me benefits?
A: Employees of uninsured employers who are injured can both sue their employer in a civil action and file a claim against the Worker’s Compensation Trust Fund at the DIA.

Q: I collected WC benefits for several months, then tries to go back to work. After a week I had to leave work due to my injury. I notified the insurance company. Do they have to resume my benefits?
A: Yes. Under the worker’ compensation law, in cases where liability has been established, if you return to work for fewer than 28 days, and are forced to leave work again due to your injury, the insurer must resume payments to you. However, you are required to report your renewed disability to the insurer, in writing, within 21 days of going back out. The insurer must resume these payments within 14 days of receiving notice from you.

Q: I came to an agreement for compensation with the insurance company (or a judge ordered the insurance company to pay me compensation). How soon do they have to pay me?
A: Compensation must be paid within two weeks of knowledge from any source that payment is due. An exception is made for employees of the Commonwealth of Massachusetts, and for employees receiving benefits from the Workers’ Compensation Trust Fund, whose checks may take a bit longer.

Q: I was injured at my full-time job, and I’m going to be out for several weeks. I also have a part-time job, and I am able to continue working there. How does this second job affect my benefits?
A: You would be required to report your earnings from the second job to the insurer for your full-time job. The insurer would pay you partial benefits, compensating you for a percentage of your lost wages. This compensation would be less than what you would have received under temporary total benefits. You would have to be covered by workers’ compensation insurance under Massachusetts law at your second job for the income to be included in your average weekly wage (i.e. – if you had a second job with the federal government, that income would not count towards determining benefits under state law.)

Q: I am back to work after receiving workers’ compensation benefits. However, I am still undergoing treatment for my injury, and I must take time off from work to go for my therapy sessions. Does the insurance company, or my employer, have to pay me for the time that I’m out?
A: If you return to work, but continue medical treatment, your employer would NOT be required to pay you for the time you miss. The insurer must reimburse you for reasonable travel expenses. You are compensated for lost work time only if you are going for medical evaluation at the insurer’s request and the appointment conflicts with your normal, scheduled working hours. You can be compensated for lost wages while going for medical treatment only if the services you require are not available outside your normal working hours.

Q: I have a scar and a permanent loss of function, due to a work related injury. Do I get any additional compensation for this?
A: Yes, you are entitled to a onetime payment for certain scars on the hand, neck or face, and permanent loss of function. Normally you would reach an agreement with the insurance company to settle this compensation anywhere between nine months and a year from your date of injury. The delay is to let the scar or loss of function stabilize. If you can’t reach an agreement with the insurer, you can file an employee claim, and get an appointment to be evaluated by a conciliator.

Q: How long do I have to file a claim after I am injured?
A: A claim must be filed within four years of the date an employee becomes aware of the causal connection between their disability and their employment. In the case of the death of an employee, the claim must be within four years of death.

Q: I was injured on the job and I’m getting weekly checks. My employer has terminated me; are they allowed to do this?
A: Unless its union contract, or individual contract of hire, requires it, an employer does not have to hold your job open while you are unable to work due to an industrial accident. But, the workers’ compensation law does require employers to give preferential treatment in the rehiring of injured workers when they are ready to return to work.

This information was derived from the Massachusetts Department of Industrial Accidents