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Workers’ Compensation FAQ

Massachusetts Workers’ Compensation FAQs

The workers’ compensation system can be extremely complicated. We have included below answers to some frequently asked questions, as well as other pertinent information, taken from the Massachusetts Department of Industrial Accidents website. We hope you find it helpful.

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For nearly four decades, the Law Offices of Harold I. Resnic has been dedicated to protecting the rights of people who have been victimized by workplace injury.  From offices in Springfield, MA, near Hampden Superior Court and the MassMutual Center, we meet with clients Monday through Friday, 9 a.m. to 5 p.m. To schedule a free initial consultation, call today at 413.301.9124 or contact us online. There is a parking garage on site and public transportation is available as well.


What is workers’ compensation?

The Massachusetts Workers’ Compensation system is in place to make sure that workers are protected by insurance if they are injured on the job or contract a work-related illness.

Under the system, employers are required by Massachusetts General Laws Ch. 152, § 25A to provide workers’ compensation (WC) insurance coverage to all their employees. This insurance pays for any necessary medical treatment related to the injury or illness and also pays compensation for lost wages after the first five calendar days of full or partial disability.

The Department of Industrial Accidents (DIA) is the agency responsible for administering the workers’ compensation law in Massachusetts.

What are workers’ compensation benefits?

Temporary Total Incapacity Benefits (§ 34)

Who qualifies?

You qualify if your injury or illness leaves you unable to work, considering your age, training and experience, for six or more full or partial calendar days (the days do not have to be consecutive).

What are the benefits?

Your benefits will be 60 percent of your gross average weekly wage. To determine your benefits, take your actual gross earnings, including overtime, bonuses, etc. and divide this number by the number of weeks you worked at your job in order to compute your average weekly wage. Multiply that by 60 percent (.60) to come up with your approximate weekly compensation. The maximum that you can receive is the State’s Average Weekly Wage (SAWW) at the time of your injury. The SAWW is set annually by the Massachusetts Division of Unemployment Assistance.

For how long?i

You can receive these benefits for up to 156 weeks. Compensation benefits begin on the sixth day of incapacity; you will not be compensated for the first five days of incapacity unless you are disabled for 21 calendar days or more. Again, these days do not have to be consecutive.

Partial Incapacity Benefits (§ 35)

Who qualifies?

You qualify if you can still work but lose part of your earning capacity because of your injury or illness. This may include an injury forcing you to change jobs at a lower pay rate or to work fewer hours.

What are the benefits?

The maximum compensation under this section of the law is limited to 75 percent (.75) of what your weekly total temporary benefits would be. For example, if you receive $440 a week as a total temporary benefit, the most you could receive if you collected partial benefits would be $330 a week ($440 x .75 = $330).

For how long?

You can receive benefits for up to 260 weeks.

Medical Benefits (§ 13 & § 30)

Who qualifies?

You qualify if you suffer a work-related injury or illness that requires medical attention.

What are the benefits?

You are entitled to adequate and reasonable medical care as a result of the injury or illness. You are also entitled to prescription reimbursement and mileage reimbursement for travel to and from medical visits for your work-related injury or illness. For your first visit to the doctor or hospital, your employer has the right to designate a healthcare provider within the employer’s preferred provider arrangement. After that initial treatment, you have the right to choose your own healthcare providers. The insurer has the right to send you periodically to see its doctor for an evaluation of your incapacity.

Once your claim has been reported to the insurance company, the insurer must issue you an insurance card with a claim number and contact information on it. Give the claim number to your doctor so the doctor can bill the insurer directly and get pre-approval for treatment of your injury or illness. If you do not get this card promptly after your injury or illness, contact the insurer and get the number as most medical providers will not treat you without the claim number.

For how long?

You can receive benefits for as long as medical and hospital services are required due to your injury or illness.

Permanent Loss of Function and Disfigurement Benefits (§ 36)

Who qualifies?

You qualify if a work-related injury or illness results in a permanent loss of certain specific bodily functions, scarring and/or disfigurement. The scars must be located on your face, neck or hands.

What are the benefits?

You receive a one-time payment for your disfigurement and/or scarring. This benefit is paid in addition to other payments; for example, medical bills, lost wages, etc. The amount paid depends on the location and severity of the disfigurement or function loss.

If you were injured or suffered an illness prior to December 24, 1992, you have slightly different benefits. Contact the Public Information Office if you have any questions about these benefits. If you do not have an attorney, you may want to contact the Conciliation Unit once the insurer has made an offer for your scarring and disfigurement and speak to a Conciliator. The Conciliator can give you an idea of whether the offer falls within the established guidelines.

For how long?

You receive a one-time payment for your loss of bodily function, disfigurement and/or scarring.

Survivors’/Dependents’ Benefits (§ 31)

Who qualifies?

You qualify if you are the spouse or child of an employee who has died as a result of a work-related injury or illness. Children are eligible only if they are under age 18, are full-time students or are unable to work because of physical or mental disabilities.

What are the benefits?

Surviving spouses can receive weekly benefits equal to two-thirds of the deceased worker’s average weekly wage, up to the maximum of the State’s Average Weekly Wage (SAWW) in place at the time of their injury or illness.

Surviving spouses become eligible for yearly cost of living adjustments two years after the date of the injury or illness.

If the spouse remarries, $60 a week is paid to each eligible child. The total weekly amount paid to the dependent child cannot exceed the amount the spouse had been receiving.

For how long?

Surviving spouses can receive these benefits for as long as they remain dependent and do not remarry.

Burial Expenses (§ 33)

In all cases where death has occurred as a result of an injury or illness, the insurer will pay up to $4000 for reasonable burial expenses.

Permanent and Total Incapacity Benefits (§ 34A)

Who qualifies?

You qualify if you are totally and permanently unable to do any kind of work as a result of a work-related injury or illness. You do not have to exhaust your temporary benefits before applying for permanent benefits.

What are the benefits?

You will get two-thirds of your average weekly wage (or a minimum of 20 percnt of the SAWW) based on the 52 weeks prior to your injury, up to a maximum of the SAWW. You are also entitled to annual cost-of-living adjustments (COLA).

For how long?

You can receive benefits for as long as you are disabled.

When benefits may be stopped or reduced

Your benefits may be stopped or reduced for several reasons. Some of the more common reasons are:

  • It is ordered by an arbitrator, administrative judge, reviewing board or higher court
  • You have returned to work (the insurer must resume benefits if you leave work again due to the same injury within 28 days, provided that the insurer has accepted or been assigned liability for your injury)
  • The insurer has been given a medical report by your treating doctor or an impartial medical examiner stating that you are capable of returning to work, and your employer has reported in writing that a suitable position is available for you that your doctor has approved
  • You are requested to attend an evaluation by a DIA Vocational Rehabilitation Review Officer, and you refuse to attend or refuse to cooperate with the provision of vocational or rehabilitative services
  • You are asked to go to the insurer’s doctor for evaluation, and you fail to attend
  • You are imprisoned after conviction for either a misdemeanor or felony

Lump sum settlements

A lump sum is a settlement or contract between you, the insurer and, in some cases, your employer. This one-time payment may be made in place of your weekly compensation checks and certain other benefits. In accepting a settlement, you give up certain rights, so you must carefully consider whether or not settling your case is in your own best interest. No one is entitled to a lump sum; both you and the insurance company must agree to it. For more information, please visit the DIA website at www.mass.gov/dia or call the Public Information Office for a Lump Sum Brochure.

Vocational rehabilitation services

The goal of vocational rehabilitation (VR) is to return you to work earning as close as possible to what you were earning prior to your injury or illness. VR services cover all non-medical services that you may require to return to a suitable job. Services may include: evaluation of your capabilities, vocational testing, counseling or guidance, workplace modifications and/or job placement assistance/formal retraining.

If you are requested to meet with one of the DIA’s VR Review Officers, you must attend this meeting. This meeting is to determine if you are suitable for these services. If you refuse to come to this meeting, your benefits can be discontinued. If you refuse to take part in a rehabilitation program after being found suitable, your weekly benefits can be reduced by the insurance company with the DIA’s permission. For more information, please visit the DIA website at www.mass.gov/dia or call the Public Information Office for a VR Brochure.

Some frequently asked questions by injured workers

Does my employer have to keep my job open while I am out on compensation?

The Massachusetts Workers’ Compensation Law does not require your employer to hold your job open if they need to replace you while you are out. However, once you are able to return to work, § 75A of the law requires your employer to give you preference in rehiring if a suitable job is available. Visit the DIA’s website for more information at www.mass.gov/dia.

Are my workers’ compensation benefits tax free?

Under federal and state tax codes, workers’ compensation benefits are tax free.

What about my employee benefits from work? Will those continue?

The Massachusetts Workers’ Compensation Law does not require the continuation of most fringe benefits including health insurance. Talk to your personnel office about how your injury will affect your health insurance and such policies as the earning of sick and vacation time. If you are a union member, check with your union regarding benefits and obligations of your employer.

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