If you were injured or got sick because of your job in Massachusetts, you may be eligible to receive a range of benefits through the state workers' compensation system, including medical treatment and payments to cover part of your lost wages. This article explains how the most important workers' comp benefits are calculated in Massachusetts and how much you might receive. (To get these benefits, you'll need to file a Massachusetts workers' comp claim and show that your injury or illness is work related.)
Can You Get Workers' Comp Benefits in Massachusetts for COVID-19?
Under Massachusetts law, workers' comp will cover an infectious disease only when the risk of contracting the illness is inherent in the nature of your job. Even if you work in an occupation with a particularly high risk of exposure to COVID-19, however, you would also need to show that you contracted the illness while you were working and because of your job. (Mass. Gen. Laws ch. 152, §§1(7A), 26 (2020).)
In the context of a pandemic, it would be very difficult to prove that you got COVID-19 because of exposure at work rather than in the rest of your life. Some states have enacted measures to make it easier for certain employees, like first responders and healthcare workers, to get workers' comp benefits for COVID-19. Massachusetts hasn't yet joined those states, although similar bills are pending in the legislature.
If you're completely unable to work while you're recovering from your work-related injury or illness, you may receive temporary total incapacity (TTI) benefits in Massachusetts (usually known elsewhere as temporary total disability). These benefits don't start until you've been away from work for five days, unless you're unable to work for at least 21 days. TTI benefits continue until the soonest of the following:
Weekly TTI payments are calculated as 60% of your average weekly wage before your injury or illness, subject to a maximum and minimum based on the statewide average weekly wage (SAWW) at the time of your injury. You'll receive the full amount of your pre-injury wages if they were less than the minimum. (Mass. Gen. Laws ch. 152, §§ 29, 34 (2020).)
For injuries that happened in the year between October 2019 and September 2020, the maximum TTI benefits are $1,431.66, and the minimum rate is $286.33. (For other years, see the chart of maximum and minimum TTI rates in Massachusetts.)
Massachusetts pays partial incapacity benefits if you're able to return to work, but your injury or illness prevents you from earning as much as you did previously. These weekly payments will amount to 60% of the difference between your pre-injury wages and the amount you're capable of earning now, but no more than 75% of what you'd receive for TTI benefits. Also, if your actual earnings plus your partial incapacity benefits add up to more than twice the SAWW amount, the insurance company may reduce your benefits to bring the earnings-plus-benefits total down to that point.
Generally, partial incapacity benefits continue until you are able to earn your normal wage or you've received the payments for five years. However, the payments may be extended up to ten years if your injury has left you with certain types permanent disability, such as:
(Mass. Gen. Laws ch. 152, §§ 35, 35d (2020).)
In addition to any other workers' comp benefits, you may receive an award for the permanent loss, or lost function, of certain senses and body parts. The amount of the award is calculated by multiplying the SAWW by a certain number listed in a schedule, depending on the extent of your loss and the specific body part.
For example, for the total lost use of a leg, the schedule lists a multiplier of 39. If your leg was amputated because of an injury during the year before October 2020, you would receive an amount equal to 39 multiplied by $1431.66 (the statewide wage for that year), for a total of $55,834.74. If you lost 50% of your leg or its function, you would receive half that amount.
For permanent loss of bodily functions or senses not listed in the schedule, you would receive an amount that's considered fair, up to a maximum of 32 times the SAWW. You may also receive up to $15,000 if your injury has left you with permanent disfigurement, including disfiguring scars on your face, neck, or hands. (Mass. Gen. Laws ch. 152, § 36 (2020).)
If doctors determine that you are permanently and totally incapable of working as a result of your injury or illness, you may receive weekly payments for as long as your disability continues. These benefits will be equal to two-thirds of your average weekly wage, subject to the same maximum and minimum as for temporary total benefits. (Mass. Gen. Laws ch. 152, § 34a (2020).)
Massachusetts workers' compensation also provides additional benefits, including:
If your employer's insurance company has denied your workers' comp claim or is balking at paying any benefits, it's time to speak with a workers' comp lawyer who can evaluate your case and help you get all of the benefits you deserve. (Learn more about how a good workers' comp lawyer can help.)
If you're worried about the expense, it may help to know that under Massachusetts law, workers' comp attorneys are paid only if they win benefits for you. If you settle your case, the lawyer will receive 15%-20% of the settlement, depending on the timing. But the insurance company has to pay your attorney's fee if you win benefits another way—through an award after a court hearing or because the insurer changed its position after initially denying your claim.