Articles Tagged with Massachusetts workers’ compensation

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When a worker is injured or becomes ill while on the job in Massachusetts, he or she may be entitled to workers’ compensation benefits. These benefits may include both the cost of medical treatment and wage replacement while the worker is unable to work. Sometimes a worker is hesitant to file a workers’ compensation claim because of a pre-existing condition. While a pre-existing condition can make a workers’ compensation claim a bit trickier, it does not preclude a worker from receiving benefits.

Pre-Existing Conditions

To be clear, a worker cannot receive workers’ compensation benefits in Massachusetts for an injury that occurred prior to beginning work with the current employer or for an injury that occurred while the worker was not working. However, if a worker is injured on the job and that injury combines with a pre-existing injury, or exacerbates a pre-existing injury, the worker may be entitled to benefits.

A recent case before the Massachusetts Appeals Court illustrates the pre-existing condition standard well. In Goodwin v. National Grid, No. 11–P–2088, a 55-year-old pipefitter injured his neck while at work one day. After testing and a complete examination, doctors concluded that the worker had extensive degenerative disc disease as well as some other pre-existing neck and back problems prior to the injury that occurred at work. The physician who examined the worker and reviewed his medical history for purposes of workers’ compensation concluded that his pre-existing conditions were responsible for 60 percent of his injuries and his work injury was responsible for the other 40 percent. Although the insurer denied benefits to the worker based on the argument that the 40 percent attributable to the work injury was not sufficient to be entitled to benefits, the court disagreed.

The standard applied by the court was based on Section 1(7A) of c. 152, as amended by St.1991, c. 398, § 14, which provides in pertinent part:

“If a compensable injury or disease combines with a pre-existing condition, which resulted from an injury or disease not compensable under this chapter, to cause or prolong disability or a need for treatment, the resultant condition shall be compensable only to the extent such compensable injury or disease remains a major (emphasis added) but not necessarily predominant cause of disability or need for treatment.”

To qualify for benefits, a workplace injury must be considered a major cause of the injury on which the claim for benefits is based. As the court’s decision illustrates, to be considered a major cause it is not necessary that the work injury be responsible for more than 50 percent of the injury. For a worker with a pre-existing condition, this means that an additional injury, or an accident that exacerbates an old injury, may still lead to eligibility for workers’ compensation benefits in Massachusetts.

If you have suffered a work-related injury or illness in Massachusetts, you may be entitled to workers’ compensation benefits. If you are concerned about your employer’s workers’ compensation coverage, ask an experienced Massachusetts workers’ compensation attorney what you should do.

Contact the Massachusetts workplace injury lawyers at Kantrovitz & Associates, P.C., at 800-367-0871 or through our online contact form.

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If you are injured or become ill as a result of your job in Massachusetts, you may be entitled to workers’ compensation benefits. The type, amount and duration of the benefits will depend on the specific facts and circumstances of your case. You may be tempted to fudge a little on the application or exaggerate your injury to extend or increase your benefits. Do not do this!

Workers’ Compensation Laws

It is very important for an injured worker to understand that the workers’ compensation laws are just that – laws. While they are in place to protect injured workers, they also provide civil and criminal penalties for both workers and employers who violate the laws. Some common examples of workers’ compensation violations include:

  • Reporting an injury that did not occur.
  • Claiming that injuries were suffered on the job when, in fact, they occurred outside the workplace.
  • Exaggerating the severity of an injury.
  • Continuing to claim weekly benefits when the injury has healed or the symptoms have lessened.
  • Working “under the table” while collecting workers’ compensation injuries.

If you are a workers’ compensation claimant and you have the strange feeling of being watched, you may not be paranoid. Someone actually may be watching you. Workers’ compensation insurers often send out investigators to catch claimants doing something they shouldn’t, such as working at a job, cutting the grass while claiming to be ill, or walking the dog while claiming to be unable to walk. Workers’ compensation insurers lose a significant amount of money to fraud, so they have an incentive to pursue those who violate workers’ compensation laws.

Civil and Criminal Penalties

A worker who is caught violating a rule or law may face civil or criminal penalties. For starters, the Department of Industrial Accidents may suspend current benefits or deny future benefits. A worker could also be ordered to pay back benefits received for wage replacement or medical treatment. Finally, if the violation is serious enough, a worker could face criminal charges.

If you are a Massachusetts worker, and you have suffered an injury or illness, you may have a valid Massachusetts workers’ compensation claim, but you must proceed with caution. The rules can be confusing, causing an unintentional violation. If you are unsure where you stand under the workers’ compensation rules, or are concerned that you may have violated a rule, consult an experienced Massachusetts workplace injury attorney right away. To find out what legal options you have for a work-related injury, the workplace injury lawyers at Kantrovitz & Associates, P.C. can be reached by calling 800-367-0871 or by using our online contact form.

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The 63-year-old owner of a roofing and siding business in Nantucket, Massachusetts, pleaded guilty recently to five counts of workers’ compensation fraud, according to a report by the Insurance Journal. He was sentenced in Suffolk County Superior Court to two years of probation and ordered to pay $42,000 in restitution as a result of a plea agreement.

The business owner was accused of failing to accurately report his total payroll and number of employees as well as misclassifying his business and the type of work his employees were doing.

Unfortunately, business owners engage in behavior such as this far too often as a way to try and avoid paying workers’ compensation premiums.

“Premium avoidance is a serious crime that undermines the insurance system and puts lawful employers at a disadvantage,” the report quoted Massachusetts Attorney General Martha Coakley as saying. “The prosecution of these schemes prevents the increase in insurance premiums that often result from these crimes.”

Workers’ Compensation Fraud

In Massachusetts, as in all states, an employer is required by law to carry workers’ compensation coverage that will cover on-the-job accidents suffered by employees. An employer is also required to accurately report vital information regarding employees and the type of work they perform so that the liability carrier can determine the cost of that coverage. Sometimes an employer tries to minimize the number of employees working for the company, or minimize the potential risk by miscategorizing the type of work an employee does, in order to hold down workers’ compensation premiums.

Because premiums are based on the number of employees, as well as the likelihood of injuries, the potential for fraud is great. The Nantucket employer was charged with hiding the fact that his employees were engaged in hazardous work.

As Attorney General Coakley indicated, this type of fraud ultimately hurts everyone, including the workers whom the workers’ compensation system is intended to protect. If you believe that your employer is committing workers’ compensation fraud, you can report your concerns to the Massachusetts Department of Labor and Development, Office of Investigations. As an employee, you have a right to request information concerning your employer’s workers’ compensation provider. If your employer refuses to provide you with the information, you can report that refusal to the Office of Investigations or you may wish to contact an experienced Massachusetts workers’ compensation attorney.

If you have suffered a work related injury or illness in Massachusetts, you may be entitled to workers’ compensation benefits. Eligibility for benefits depends on the unique facts and circumstances of your injury or illness. If you are concerned about your employer’s workers’ compensation coverage, ask your attorney what you should do. A Massachusetts workers’ compensation attorney can review those facts and circumstances and advise you about your legal options. Contact the workplace injury lawyers at Kantrovitz & Associates, P.C., by calling 800-367-0871 or by using our online contact form.

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In Massachusetts, a worker who is injured or becomes ill as a result of employment may be entitled to Massachusetts workers’ compensation benefits. An eligible worker may receive benefits that cover treatment of the injury or illness as well as total or partial wage replacement. A worker who claims these benefits, yet continues to work, can be charged with a crime in Massachusetts.

The Massachusetts workers’ compensation system is a no-fault system, meaning that an injured employee is not required to prove negligence on the part of the employer. If the injury or illness occurred within the scope of employment, then a claim for benefits will likely be approved. If, however, a worker applies for wage replacement benefits, the worker must certify that he or she is unable to work and that he or she did not work for the time period for which benefits are claimed.

Wage replacement benefits can be total or partial. Total wage replacement benefits are based on a worker not being able to work at all, whereas partial wage replacement benefits replace only the income the worker loses as a result of an injury or illness. If, for example, you were working 40 hours a week and a work-related injury causes you to be able to work only 20 hours per week, you may qualify for wage replacement benefits for the 20 hours you cannot work.

A worker who claims wage replacement benefits is certifying to the Commonwealth of Massachusetts that he or she did not work during the time period claimed. If the worker did actually work, this is a crime. Not only can the worker lose the right to workers’ compensation, but criminal fraud charges can be filed against the worker.

In Massachusetts, the Insurance and Unemployment Fraud Division of the Attorney General’s Office as well as the Insurance Fraud Bureau investigate claims of fraudulent workers’ compensation claims. In 2012, the Attorney General’s Office obtained more than $1.6 million in restitution orders in 32 matters. These fraudulent claims raise the costs associated with the workers’ compensation system for everyone involved, which is why the Commonwealth vigorously investigates and prosecutes offenders. To report suspected workers’ compensation fraud, call 800-32FRAUD or use the IFB Hotline Tip Form.

Get Advice from a Workplace Injury Lawyer

If you have suffered a work-related injury or illness in Massachusetts, you may be entitled to workers’ compensation benefits. Eligibility for benefits depends on the unique facts and circumstances of your injury or illness. An experienced Massachusetts workers’ compensation attorney can advise you about your legal options. The workplace injury lawyers at Kantrovitz & Associates, P.C., can be reached by calling 800-367-0871 or by using our online contact form.

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The recent snowstorm that blew through Massachusetts reminds us that winter is far from over. Winter driving hazards are still a major concern. Many workers are injured each year in car accidents on their way to or from work, during their lunch hours, while traveling for work and while running errands for an employer. If you are injured in a car accident while doing any of these things, are you eligible for Massachusetts workers’ compensation benefits? The answer is not a simple “yes” or “no”.

The Scope of Employment

For an employer to be held liable for injuries caused in any type of accident, the injuries must have occurred while the employee was “within the scope of employment.” The precise definition of this phrase has been argued and litigated by scholars, attorneys and courts for many years.

Courts tend to look at two things to determine whether an employee was “within the scope of employment” for purposes of workers’ compensation. First, they look at what the worker was actually doing at the time of the accident. Was it something that was clearly within the employee’s job description? Was it something the employee had done before for the employer? Was it something the employer should reasonably have foreseen that the employee would be doing? The second prong of the test looks at whether the activity in which the worker was engaged was in furtherance of the employer’s business. In other words, did the employer stand to gain by what the employee was doing?

A Workers’ Compensation Attorney Can Review Your Case

As you can see, determining whether a car accident occurred while the employee was in the scope of employment is not always easy. In some cases it is clear. For example, if the employee’s job was to deliver pizzas and she was involved in an accident while delivering a pizza, then she was clearly within the scope of employment; however, if she took a particularly dangerous route, was speeding or driving recklessly or did something else unorthodox during the trip, the employer could argue that she was not within the scope of employment when the collision occurred. Likewise, although it may seem that an employee would clearly not be within the scope of employment if a car accident occurred during his lunch hour, that may not be the case if his employer had asked him to pick up something for the office while he was out.

Whether injuries sustained in a car accident are compensable under Massachusetts workers’ compensation laws depends on the unique facts and circumstances surrounding the accident. Only an experienced Massachusetts workers’ compensation attorney can review those facts and circumstances and advise you about your legal options. Contact the workplace injury lawyers at Kantrovitz & Associates, P.C., can be reached by calling 800-367-0871 or by using our online contact form.

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Some Massachusetts workers such as police officers, firefighters and paramedics work in inherently dangerous situations on a daily basis. The majority of workers, however, expect to go to work each day, do their job, and come back home without experiencing anything that could cause long-term psychological scars. Sometimes though, unexpected events in the workplace do cause psychological issues for a worker. When this occurs, Massachusetts workers’ compensation benefits may be available.

Imagine, for example, that you are employed as a cashier at a small mom-and-pop grocery store. You have worked there for more than 10 years without anything unusual happening when one day the store is robbed. In the course of the robbery, you are held at gunpoint. Not surprisingly, you begin to have nightmares, suffer from flashbacks and are unable to concentrate at work, or your loved ones notice a serious change in your personality. You could be suffering from post-traumatic stress disorder. As a result, you could be entitled to benefits under the Massachusetts workers’ compensation system.

Proving the Link between Work and Disability

In Massachusetts, a worker is potentially eligible for workers’ compensation benefits for mental or emotional disabilities, such as PTSD, if you can prove that a workplace incident or situation was a contributing factor in your mental or emotional disability. A physical injury suffered in the workplace can also sometimes be the cause of a secondary emotional or mental disability. For example, if you were seriously injured in a workplace accident you may now be suffering from the emotional trauma that frequently follows a physical injury. Your emotional disability may also be compensable through the Massachusetts workers’ compensation system. Along with wage replacement benefits, you may be entitled to therapy for your disability and vocational rehabilitation if warranted.

Proving the nexus between your disability and your workplace can be difficult. In the above example of the grocery store robbery, the correlation between the event and the emotional injuries may be evident; however, many emotional or mental disabilities are caused by workplace incidents or situations that are not as obvious. For this reason, many claims submitted to the workers’ compensation system based on mental or emotional disabilities are initially denied. Consulting with an experienced Massachusetts workers’ compensation attorney can greatly increase the chance that your initial claim for an emotional or mental disability will be approved.

A Workers’ Compensation Attorney Can Help

If you have already filed a workers’ compensation claim, and it was denied, all is not lost. You have the right to appeal the denial; however, your chances of approval diminish at each stage of the process, making it even more important that you consult with an experienced workplace injury attorney as soon as possible.

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If you have been injured in a workplace accident in Massachusetts, you may be entitled to workers’ compensation benefits. Workers’ compensation comes in two basic forms – wage replacement benefits and medical treatment benefits. After you begin receiving benefits, they could be stopped for a variety of reasons.

When you are injured or become ill on the job, your employer will report the injury or illness to its workers’ compensation carrier as well as to the Department of Industrial Accidents. There is a one-week waiting period before benefits can be paid out for all workers’ compensation claims. After the initial waiting period, you will begin to receive weekly wage replacement benefits, and your medical expenses relating to the injury will be covered if your claim has been approved.

The following circumstances could cause your benefits to stop:

  • You return to work. If you return to work full-time, your benefits will stop entirely. If you are able to work only part-time, you may continue to receive wage replacement benefits each week.
  • A court orders your benefits to cease. This can occur for a variety of reasons. Usually it is the result of an appeal or other court hearing to determine the status of your claim.
  • The workers’ compensation carrier received a notice from your treating doctor saying that you are capable of returning to work. This must be accompanied by a notice from your employer that a position is also available for you to return to work.
  • You fail to keep a scheduled appointment for an evaluation. Sometimes, the DIA will order an evaluation by a vocational rehabilitation officer or you will be ordered to submit to an evaluation by the workers’ compensation carrier’s doctor. If you fail to attend, your benefits could be stopped.
  • Technical reasons. Sometimes documents that are required to be filed with the DIA are not timely filed or there is an error in a document. This can cause your benefits to be stopped.

If you think your benefits were stopped without good cause, you have the right to appeal or request that they be reinstated. It is usually much easier to prevent your benefits from stopping than it is to get them started again. For this reason, you should consider consulting with an experienced Massachusetts workers’ compensation attorney as soon as you realize that you may have a compensable on the job injury or illness claim. Your attorney can help make sure that all the proper documents are timely filed and that you comply with all requirements to ensure that your benefits are not unjustly stopped.

If you have suffered an injury or illness as a result of a Massachusetts workplace accident or incident and would like to know your legal options for a work-related injury, the workplace injury lawyers at Kantrovitz & Associates, P.C., can be reached by calling 800-367-0871 or by using our online contact form.

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If you have suffered a work-related injury or illness in Massachusetts, you may be entitled to benefits under the Massachusetts workers’ compensation system. Along with wage replacement while you are recuperating, the system also provides medical treatment for your injury or illness if you qualify.

Understandably, injured workers are often confused about their right to choose a doctor. Although each claim is unique, the following general guidelines may help you understand your rights if you have suffered a work-related injury or illness in Massachusetts.

Filing Your Claim

Before you do anything else, you need to report your injury to your supervisor. In the normal course of events, your employer will then file the necessary paperwork to report your injury and get your benefits approved through its workers’ compensation carrier. Your employer must file the required documents within seven calendar days after the fifth calendar day of your injury or illness. This makes it very important that you notify your employer in writing immediately after your injury.

Initial Evaluation

Once your claim has been filed, you may be required to be seen for an initial evaluation by what is referred to as a “preferred provider.” Essentially, this is a type of workers’ compensation insurance plan that calls for all claimants to have an initial evaluation by a physician who is part of the “preferred provider” plan. Many people have preferred provider health insurance plans that operate in much the same way. Although this initial evaluation may be required, you are not obligated to continue treatment with the physician who completes your initial evaluation.

Choice of Doctor

After you have had an initial evaluation with the preferred provider, if applicable, you then have the right to be seen by a doctor of your choosing. Furthermore, your employer is legally required to provide you with a list of all physicians or specialists in the area who are on the preferred provider list. You may also have the right to seek a second or even a third opinion if you are not satisfied with the initial doctor’s evaluation.

Treatment Disputes

Along with your right to choose your doctor, you have a say so in the treatment you receive. Sometimes, your doctor will recommend a course of treatment that the workers’ compensation system does not agree with or does not wish to pay for initially. You have a right to dispute this refusal to pay for treatment. You also have a right to negotiate the amount that the system is willing to pay for services, such as a surgery.

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When most people think of injuries that qualify for Massachusetts workers’ compensation benefits, they first think of injuries from construction accidents or vehicle crashes. While such cases certainly qualify for workers’ compensation benefits, injuries that take place in an office setting can also qualify. By definition, any injury sustained while “in the scope of employment” is potentially eligible for workers’ compensation.

There is a long list of office-worker injuries that could provide the basis for workers’ compensation benefits in Massachusetts, according to attorneys who often represent people injured in workplace accidents. Here are some of the common ones:

Carpel Tunnel Syndrome

This injury occurs from continuous or long-term pressure on the median nerve in the wrist, which supplies feeling to the hand and fingers. Office workers who spend the majority of their day on a computer frequently develop carpel tunnel syndrome if their work station is not ergonomically set up.

Repetitive Stress Injury

These injuries are the result of overuse of a specific part of the body. For example, if you use your arm eight hours a day working a postage meter, you could eventually suffer a repetitive stress injury in your arm. Workers often think these aches and pains are just part of the job, or part of growing old, when in fact they are actually compensable work-related injuries.

Falls/Trips/Slips

An employer in an office setting has the same duty to provide a hazard-free workplace as an employer on a construction site. A worker who trips over a power cord, slips on a wet floor or falls down the stairs may have a legitimate workers’ compensation claim.

Lifting Injuries

Office workers are frequently required to lift boxes or office supplies. A pulled muscle, back strain or neck injury that results from lifting something at work may qualify for workers’ compensation benefits.

It is important that Massachusetts officer workers understand that they are not expected to simply live with injuries that occur on the job. Aches and pains that do not go away may be a symptom of a much more serious condition or injury – one that could be the result of your job. Even if your injury does not consistently require you to miss work at the moment, you should still consult a physician as soon as possible. If left untreated, those aches and pains could worsen or lead to permanent damage.

Although the Massachusetts workers’ compensation system does provide wage replacement benefits, the primary purpose is to treat injured workers. This means that if you have a qualifying injury, your medical expenses related to the injury will be covered by the workers’ compensation system.

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After steadily rising for three straight years, the cost per workers’ compensation claim in Massachusetts has shown a decrease. In fact, Massachusetts had the largest decrease among 16 states reviewed in a study conducted by the Workers Compensation Research Institute.

According to the study, the cost per claim in Massachusetts dropped 6 percent 2010. Experts believe that the decrease is due, in part, to the fact that the state is recovering from the recession. During the recession period of 2007-2009, workers’ compensation costs per claim increased an average of 10 percent each year. One statistic that points to the relationship between the cost per claim of workers’ compensation claims and the recession is that indemnity benefits decreased 11 percent from 2009 to 2010. Indemnity benefits are the benefits that are paid to a worker as wage replacement.

 Massachusetts Workers’ Compensation and the Economy

The results of the study are not surprising. Significant swings in the nation‘s economy tend to impact every sector of the workplace, including workers’ compensation. When the economy is in recession,  there are fewer employment opportunities for workers who are recovering from a workplace injury. As the economy improves, injured workers may have more opportunities to return to work or find other jobs.

Sometimes injured workers are able to return to work, though perhaps not in their pre-injury jobs. For example, a worker may be capable of answering telephones at a desk but not working on the floor of a factory. When that happens, the employer is typically required to find the worker suitable work if possible. In the middle of a recession it is harder for employers to accommodate employees who are in this position. As a result, indemnity benefits are likely to continue longer in a recession than when the economy is robust and jobs are plentiful.

The decrease in costs per workers’ compensation claim is good news for employers, insurance providers and workers. When insurance costs are down, everyone benefits. Employers save money, and those savings can then be passed on to workers. Hopefully, the decline in costs is a sign that the economy is continuing to recover from the recession.

Contact a Skilled Workers’ Compensation Lawyer in Massachusetts

If you have suffered a work-related injury or illness in Massachusetts, or have lost a family member as a result of a workplace accident, the Massachusetts workplace injury lawyers at Kantrovitz & Associates, P.C., are available to review your claim and help you decide your next move. If you would like to know what legal options you have for a work-related injury, we can be reached by calling 800-367-0871 or by using our online contact form.