If you have suffered an occupational injury or illness in Massachusetts, you may be eligible for workers’ compensation benefits. Workers' comp covers medical treatment, pays compensation for wage loss, and provides other important financial assistance. To collect benefits, you must meet certain requirements, including reporting your injury to your employer within a certain time frame.
In Massachusetts, most employers must have workers’ compensation coverage—either by purchasing a workers’ comp policy from a private insurance company or by receiving certification from the state to self-insure. (In general, only large, financially stable employers will qualify to self-insure.) The Massachusetts Department of Industrial Accidents (DIA) oversees all workers’ comp claims in the state.
Like all other states, Massachusetts has a no-fault workers’ compensation system. You do not need to show that your employer acted carelessly in order to receive benefits. As long as your injury happened on the job or was caused by your work activities, you will typically be eligible for benefits.
Eligible workers may receive a variety of benefits, including:
Notifying your employer is the first step to starting your workers’ compensation claim. In Massachusetts, you must promptly notify your employer of a work-related injury, either orally or in writing. Written notice is typically best though, as it creates a record that you fulfilled the notice requirement. If you fail to notify your employer promptly, you may lose the right to collect benefits.
It is important to provide notice and get medical treatment as quickly as possible. Employers and insurance companies are skeptical of delayed claims and tend to deny them. Giving notice and getting treatment early on will reduce the likelihood of a claim denial.
When you notify your employer, provide as much detail as possible, including:
Your employer may also ask you to fill out a written accident report. When completing the report, be as accurate as possible. Accident reports are frequently used as evidence in disputed claims, and any inconsistencies may be used against you.
After you give notice, your employer should tell you how to get medical treatment. Your employer has the right to select a doctor to provide your initial treatment. After that, you may select your own doctor. It is important to provide your doctors with accurate information about the cause of your injuries and the severity of your symptoms. Accurate information should help your doctor diagnose your condition and provide appropriate medical care—which may lead to a quicker recovery.
Once you report an occupational injury or disease, your employer typically will file an Employer’s First Report of Injury or Fatality with its insurance company and the DIA. If your employer refuses to notify its insurer, you should file an Employee’s Claim (Form 110) with the insurance company and the DIA.
The insurance company will then determine your eligibility for benefits. Its investigation may involve:
Under Massachusetts law, the insurance company must either approve or deny your workers’ compensation benefits within 14 days of receiving notice of your injury. If your claim is approved, you will start receiving disability payments and other benefits. Unfortunately, insurance companies deny many workers’ compensation claims. (For common grounds for a denial, see Denied Workers' Compensation Claims.)
If the insurance company voluntarily pays your workers’ compensation benefits, you do not need to file a formal claim with the DIA. However, if your claim is denied, you have the right to appeal the insurance company’s decision. To begin the process, you must file an Employee’s Claim (Form 110) with the DIA. This claim must be filed within four years of one of the following:
Unless your claim is very simple, you should consider hiring a workers’ compensation lawyer. The insurance company will have a lawyer and you may be at a disadvantage if you proceed without an attorney.