If you are injured on-the-job in Massachusetts, will you qualify for workers’ compensation benefits? Are you allowed to work and receive workers’ comp benefit payments at the same time? Will you need the advice and services of a Boston workplace injury attorney?
These questions will be answered in this brief discussion of workers’ compensation benefits and your rights. Workers’ compensation is insurance coverage paid for by employers to compensate their employees who are injured in workplace accidents or who become ill because of their jobs.
If you’ll continue reading, you will also learn the rules for workers’ compensation eligibility in this state and the reporting requirements for any income you may earn while you are receiving Massachusetts workers’ compensation benefits.
Who May Receive Workers’ Compensation Benefits?
Massachusetts employers are required by law to provide workers’ compensation coverage. The Department of Industrial Accidents, which oversees the state’s workers’ compensation system, provides a free web-based “Proof of Coverage” tool that can verify whether a specific employer currently has workers’ compensation insurance coverage.
However, if for any reason your employer has no workers’ comp insurance coverage, the state’s Workers’ Compensation Trust Fund will provide the coverage and benefits that an injured employee would otherwise receive through the workers’ compensation system.
Employees – but not independent contractors – may be eligible for workers’ compensation benefits if they sustain an on-the job injury or become ill as a result of their employment. Any injury or illness that is a direct result of your job is covered by workers’ compensation.
If You Are Injured in a Workplace Accident
If you’re injured on the job, obtain medical treatment immediately, and then report the incident as quickly as possible to your foreman, manager, or HR department. And even before submitting your claim for workers’ comp benefits, arrange to meet with a Boston workers’ compensation lawyer.
Your workers’ comp lawyer will make sure that your application for benefit payments is complete and accurate so that there is no reason for your application to be rejected or for your benefits to be delayed.
Can You Earn Income While Receiving Workers’ Comp?
If you work at a second job and if you want to continue there, or if workers’ compensation payments are not providing enough and you would like to earn extra income, you need to understand how that additional income may affect your workers’ compensation eligibility.
Many injured and disabled persons take physically non-demanding jobs like transcription work or answering customer service calls. If you do, that income must be reported, and the workers’ comp insurance company will adjust your benefit payments to take your earnings into account.
What Constitutes Workers’ Compensation Fraud?
You cannot take a job or work a second job that’s as demanding physically as the job where you were injured. If you receive workers’ comp because you were allegedly injured, and then you’re caught at a physically demanding job, you could be charged with fraud and face legal penalties.
You could also be charged with workers’ comp fraud if you are working while receiving workers’ compensation benefit payments, failing to report your income, and getting paid in cash “under the table.”
Workers’ compensation fraud occurs when a person willfully makes a false statement or conceals information in order to receive workers’ compensation benefit payments that he or she is not entitled to.
How Is Workers’ Comp Fraud Investigated?
A workers’ compensation insurance company may scrutinize your posts on social media sites or even follow you and take surveillance video to obtain evidence that can be used to deny your workers’ comp benefits.
And in Massachusetts, the Attorney General’s Office and the state’s Insurance Fraud Bureau also investigate fraudulent workers’ comp claims. Fraudulent claims raise the cost of workers’ comp for everyone, so Massachusetts aggressively prosecutes workers’ compensation fraud.
What Are Workers’ Comp Partial Disability Benefits?
If you worked at a second job before you were injured, in some cases, you might be able to keep that job while you receive workers’ compensation payments, or you might be able to start at a different job.
You may receive workers’ comp partial disability benefits if you can work but you’ve lost part of your earning capacity because of your work-related illness or injury. Partial disability benefits cover 60 percent of the difference in your average weekly earnings before and after a work-related illness or injury.
Each situation is different, so to make sure that you are in compliance with the law – and that you’re not at risk for a fraud prosecution – report all of your income and any changes in your income, and have personalized advice from the right Boston workplace injury attorney.
Could Your Workers’ Comp Benefits Be Denied?
You will also need a workers’ compensation attorney if your application for benefits is rejected by your employer’s workers’ compensation insurance company. In Massachusetts, about half of all workers’ compensation claims are denied.
However, your attorney may ask on your behalf for an appeal hearing before the Massachusetts Department of Industrial Accidents. You will need to complete some legal paperwork – again, with your attorney’s help – and attach any medical documentation that supports your appeal.
How Are Appeals of Claim Denials Handled?
When it receives your appeal request, the Department of Industrial Accidents will schedule a “Conciliation” meeting to try to reach a voluntary agreement between you and your employer’s insurance company.
If no resolution can be reached, a “Conference” will be scheduled before an Administrative Judge. That is where your attorney will argue on your behalf and present evidence that you are entitled to workers’ comp benefits. Either side may then appeal the decision of the Conference.
When Should You Contact a Workers’ Compensation Attorney?
It isn’t necessarily easy to obtain workers’ compensation benefit payments, even after a serious workplace injury. Even if you meet all of the deadlines and income reporting requirements, your claim for benefits could still be rejected for a variety of reasons. Appeals are complicated and take time.
If you are injured on-the-job, you should have the guidance of a Boston workers’ compensation lawyer from the very beginning. But if you applied for benefits on your own and your claim was denied, you should still have an attorney handle your workers’ compensation appeal.
Your first legal consultation with a Massachusetts worker’s comp lawyer is provided with no cost or obligation, and no attorney’s fee is paid unless and until your attorney prevails with your claim for workers’ compensation benefits.