Workers compensation (WC) is a form of insurance that protects employees and their families, as well as employers, when a worker suffers from a work-related injury, illness, or death. Massachusetts mandates that all employers provide workers compensation benefits to all employees.
Workers compensation is a “no-fault system,” meaning that it protects both employees and employers. It protects employees with medical care and partial wage replacements, and it protects employers from potentially damaging lawsuits, according to the Executive Office of Labor and Workforce Development (EOLWD). The Department of Industrial Accidents (DIA) ensures that employers provide employees with WC benefits, and is in charge of resolving any benefits or claims disputes.
Eligibility and Coverage
Almost all workers in Massachusetts are eligible for workers compensation benefits, regardless of the number of hours worked or payment. You are eligible for workers compensation if you work: full-time or part-time, as a seasonal worker, volunteer, or those who receive no pay. Coverage is provided to those who are not United States citizens, or who are undocumented workers. If you are self-employed, you must seek out your own workers compensation insurance.
“We always encourage small business owners to cover themselves by a workers comp policy,” said Brenda Dessert, commercial sales representative at McGrath Insurance. “If a business owner is injured in the course of work, they would have medical bills and lost wages just the same as an employee would. Many small business owners don’t realize that they can cover themselves with workers comp- even if they don’t have employees, they can still get a policy to cover themselves.”
To receive the benefits of workers compensation, the alleged injury, illness, or death needs to be related to work. This does not mean the alleged incident has to take place in the place of employment, such as when traveling as part of the job. However, any injuries that take place during the commute to or from work are not covered under workers compensation.
With this coverage, and depending on the specific WC case, workers can receive medical benefits, cash benefits for loss pay, cash benefits for scarring or loss of body function, and vocational rehabilitation benefits. In the event of a worker’s death, the surviving spouse will receive a weekly payment equal to 2/3 of the deceased’s average weekly pay (no greater than the state maximum compensation rate), according to MassResources.org.
For more information on workers compensation benefits and what qualifies as a work-related injury, illness, or death, contact the Department of Industrial Accidents at 1-800-323-3249.
Claim Reporting Requirements
When a worker is unable to earn wages for five full or partial days of work, consecutive or non-consecutive, due to a work-related injury or illness, that employee becomes eligible for weekly benefits through workers compensation.
Once the employee reports the incident, the employer must then file the Employer’s First Report of Injury or Fatality- Form 101 to the Department of Industrial Accidents (DIA). Effective January 1, 2014, this form must be filed electronically to the DIA within seven calendar days, not including Sundays or holidays, from the fifth full or partial day the employee is out due to the claim. If the employee does not immediately report the injury or illness, then the employer has seven days from the notification date to file the form.
Employers that do not file this form to the DIA three or more times within a year will be fined $100 for each violation. If any claims seem suspicious, report them to your insurance carrier for review.
Tips for a Safer Workplace
- Educate and train workers on the safety regulations effective in the workplace. Reward employees who work carefully, and create a safety committee to communicate ways to better the company’s overall safety measures.
- When looking into a new-hire, make sure any physical requirements for the job are included in the description. Use drug tests and pre-employment physicals as a way to prevent future claims. Be careful of workers with a history of workers comp claims.
- Get employees back to work quickly with temporary jobs and occupational therapy.
*This article is written for informational purposes only and should not be construed as providing legal advice.