Frequently Asked Questions

If an employee is terminated from employment he/she is entitled to receive payment of any wages due on the day of the discharge. Vacation pay is considered earned wages and is also due, while sick time is generally not.

There is nothing in the Massachusetts Workers’ Compensation law that forbids an employer from terminating your employment while you are out of work collecting workers’ compensation benefits.

The short answer is no. In Massachusetts, Workers’ Compensation is an “exclusive remedy”. This means that if you are injured at work and your employer carries workers’ compensation insurance you may only recover benefits under the Workers’ Compensation System unless a third party is responsible for causing your injury.

A third party is someone other than your employer who is responsible for causing your injury. If you can show a third party was at least negligent, you will be able to file a separate civil lawsuit against that person(s).

In many people’s minds, if they cannot return to their usual type of work, they are disabled. However, under the Massachusetts Workers’ Comp law, the ultimate question is whether you are capable of earning any income, even with limitations that would prevent you from returning to your old job. If your earnings are lower than what your previously made, you are considered “partially” disabled and eligible for partial disability benefits.

PWOP stands for Pay Without Prejudice Period. By law, the workers’ compensation carrier can pay weekly benefits for up to 180 days without prejudice. This means two things: (1) the insurance company has not formally accepted liability for the injury even though it is paying benefits and (2) it can reduce or terminate the benefits at any point by sending a 7-day notice via certified mail.

An insurance company will often send a letter asking you to sign a Form 105 – An Extension of the of the Pay Without Prejudice Period. By signing this form, you agree to extend the PWOP period for an additional 180 days.

Injured workers often misunderstand what the Form 105 does. Many think it means that benefits will be paid for an additional 180 days. Signing the Form 105 does not guarantee your receipt of any additional benefits even for one day, it merely allows the insurer to continue to pay you without prejudice, to avoid liability for your claim and retain the right to reduce or terminate your benefits without going to court and getting a judge’s permission.

To pursue a claim for weekly cash benefits or medical treatment, you will need medical evidence from your doctor(s) stating what your medical condition is, that your work injury caused it, what treatment you need and whether you are able to work.

The reason you hire an attorney is to have support and guidance through a confusing process and a difficult time in your life. Hiring someone who specializes in this area of the law ensures you will get the best possible result in your case. Insurance companies will deny benefits whenever they can, but you don’t have to take “No” for an answer, we don’t.

Utilization Review is a process that determines what medical treatment is reasonable and necessary for your type of injury. At the initial stage of the review, a nurse normally reviews the request for treatment and makes the decision based upon medical guidelines. If the treatment is denied, you have the right to appeal the decision and have your doctor speak with a doctor of the same medical specialty at the utilization review company. If the request is denied a second time, you then have a right to file a claim in court.

Know Your Options. Most people never think about being unable to work or the devastation caused by losing an income. When an unexpected injury or illness happens, your life as you know it changes instantly and possibly forever. You may have to seek benefits you never thought you would need, want or knew existed. Consult an attorney as soon as possible to learn your options.

If the condition is severe, the person may qualify for Social Security Disability or Supplemental Security Income benefits. If the condition occurred as a result of a physical or mental trauma at work, he/she may qualify for Workers’ Compensation or Accidental Disability benefits if he/she was employed by a municipality or the state government.

A company located outside of Massachusetts that does work in Massachusetts, must carry workers’ compensation insurance. The Department of Industrial Accidents (DIA) performs routine investigations at work sites around the state to ensure that employers have valid workers’ compensation policies in effect to cover any workplace injuries. If a DIA investigator determines that a company does not have proper coverage, he/she will issue a Stop Work Order (SWO).

Only employees who pay into the Massachusetts Public Retirement system, who suffer a workplace accident, are potentially entitled to Accidental Disability Retirement (ADR) benefits. Workers’ Compensation benefits are available to any employee who has sustained a work injury whether they work for a public or private employer. Although these benefits have elements in common there are significant differences and eligibility for one benefit does not guarantee receipt of the other.

If you pay into the Massachusetts Public Retirement system you may qualify for Accidental Disability Retirement. This includes state, town, city and county workers. You must have been injured during the actual performance of your duties and be incapable of returning to your former job.