Workers’ Compensation Simply Defined
Workers’ compensation in the State of Massachusetts is primarily a wage replacement system. If somebody has a workplace injury or illness and they’re unable to work, it provides a percentage of somebody’s average weekly wage and that percentage is taken tax-free. The percentage varies relative to the extent of disability somebody has.
Additionally, worker’s compensation provides medical treatment, that under the statute, is fair, reasonable and medically necessary to the industrial accident or the illness. It also provides some other side benefits such as prescriptions, and any other out-of-pocket expenses. Furthermore, the insurer is supposed to reimburse the injured employee traveling expenses of .45 cents a mile, round trip to and from the doctor. We recommend our clients to keep a log once a month for travel distances relating to the injury, and submit that and the insurance company.
Workers’ compensation all comes back to a wage replacement system for people that can’t work because of injury, and the additional hardships that come with the injury. It enables somebody to get better and/or get the treatment that they need.
How We Can Help
We will file a claim to start your benefits, or fight to prevent a discontinuance of your current benefits immediately. The Massachusetts Workers Compensation Law and Statute provides benefits are paid to you tax free without question of fault if you have been hurt at work, or have a work related illness. Our Workers Compensation Attorneys work quickly on your behalf to secure your weekly money benefits and necessary medical benefits the Massachusetts Workers Compensation Statute was designed to provide. Keeping you informed along the way.
For more than ten years we have successfully helped injured workers in Massachusetts receive and maintain their workers compensation benefits. We only get paid if you win your claim. This means you never pay out of pocket for our services. Too often an injured workers claim for benefits is denied. Contact us today for a free no obligation case evaluation by clicking here, or call us at 617-825-0965 to speak with our Massachusetts Workers Compensation lawyers.
The Types of Cases We Handle
Fitzpatrick & Associate handles any injury or illness. This ranges anywhere from occupational exposure to someone who works in a laboratory. We’ve handled several of these cases. For example, perhaps there’s a substance that’s being used in the laboratory that the employee has an allergic reaction to. If that creates a disability or an illness, that’s covered under the worker’s comp statute. We handle complex cases like that one, and all the way down to the obvious injuries, such as somebody who lifts something up and hurts their back. That’s also covered, and we’ve had a multitude of those cases. We’ve also handled cases that are a little more complicated such as cardiac event type cases, like exertion cases.
We’ve had individuals for example, who delivered produce and had to carry a large dolly with significant weight. As it was being pulled over a curb, that individual sustained a heart attack. It was established to be arising out of the course of employment, because it was the job duties and the exertion that resulted in that cardiac event. Those are complicated cases. We’ve handled cases with catastrophic injuries for individuals that will never be able to work again. We’ve seen injuries that the mechanism of injury seems simple, but then the injury becomes such that it’s life-changing.
For example, we saw a client with a minor fracture on the leg. Through the series of operations and infections, that individual ended up losing the leg. It was all arising out of that original injury that was all causally related, so we knew we should compensate that person at the end of the day. We’ve represented people in all sorts of forms, from the physical to mental health injuries. People can have significant injuries as far as mental health, depression or anxiety. If it’s arising out of the course of employment, again, it can’t be like a disciplinary matter. “I don’t like the way you’re working” wouldn’t be grounds for a mental health injury, but there are certain things that can happen at the workplace where mental health issues arise and they’re causally related to the injury.
They’re tough to prove, but for example, we had a client who was working in a dialysis lab. She inadvertently got stuck by a needle. As a result, she was afraid that she had accumulated some kind of disease from the individual. It creates such anxiety. She ended up under the care of a psychiatrist, which became a legitimate work injury.
A lot of these individuals with mental health claims started with physical injuries. Maybe they can never work again, but as a result of that, they have issues with mental health. It wasn’t originally a mental health claim, but you filed to join that claim to the underlying bodily injury.
The cases that are purely mental health as some kind of incident within the organization are tricky, but if you can tie it to a physical injury or an actual event, then it becomes a little bit easier. They are just as valid case, purely mental health arising out of the course of employment.
How The Workers’ Compensation Benefits Process Works
After you filed your claim, the case will get marked as a conciliation. The best way I describe that is an informal meeting between the attorneys and a conciliator. It doesn’t take place in a courtroom, it takes place in an office. At that point, if you are the moving party, we file the claim. Our job is to put on a prima facie case or a minimal amount of evidence to sustain the burden that you have suffered in industrial accident, and the disability or treatment is causally related to that. If you establish that burden, the conciliator then will refer the case up to an administrative judge to be heard. The conciliator has no authority to get the insurance company to pay or even deny a claim any further.
They may encourage a resolution or an agreement short of the judge, but if they don’t, it gets referred out to the judge. At that point, the next stage is a conference. The conference is an oral argument between the attorneys. Most employees don’t come to the conciliation. You don’t need to, but when there’s a judge involved, you must be present. We then present all of our evidence and an oral argument to the judge why you’re entitled to benefits or treatment, give an overview of your history, and a history of the injury and the treatment.
The attorney from the other side will get up and indicate why they believe your case should be denied at that time. Whichever party doesn’t get what they want, or only gets part of what they want, will file an appeal of the conference order. What’s important, is that even though that appeal is being filed, if you get an order for benefits or treatment, the insurance company has to pay you under that order. This is required even though the appeal is pending. At that point, it would be scheduled for a hearing, which is essentially a trial where witnesses are put on the stand, and a testimony is taken. Prior to the trial, you get marked up for a medical examination. It’s an 11A exam. It’s the court’s doctor.
That court’s doctor looks at the insurance company’s medical evidence, our medical evidence, and renders an opinion to the court. All of those things are utilized at the time of a trial. At the time of a trial, a decision, a written decision, is issued by the judge in a timely manner. The appeal process at that point is, if one of the attorneys feel that the hearing decision is deficient as a matter of law, filing an appeal to the reviewing board. The reviewing board composes of six judges, and they have the right to either overturn the hearing decision. They may also remand it back down for further hearing.
If a party is not happy with the decision of the reviewing board, you have the right to refer it up to the Massachusetts Court of Appeals for further oral argument.