Massachusetts law requires most employers to have workers’ compensation insurance policies to protect their employees from the consequences of work-related injuries and illnesses. Most cases involve work conditions that lead to injury or illness on the premises. Workers’ compensation can also cover pre-existing conditions that have worsened due to workplace activities and conditions that arise due to compensation-administered treatments.
While many employees may believe they need to suffer a direct injury to qualify for workers’ compensation, it’s not necessarily the case. Occupational diseases, heart attacks, chronic trauma, and mental illnesses that are the result of work conditions, such as heavy stress, can also qualify for workers’ compensation. The same applies to injuries suffered on the job premises or while traveling for work-related purposes.
Depending on the extent of your condition, you can qualify for different types of benefits.
When your injury or illness leaves you unable to work for six or more full or partial calendar days, you can qualify for temporary total incapacity benefits. These benefits provide you with a percentage of your average weekly wage for up to 156 weeks while you are unable to attend work. You do not need to miss the six or more days consecutively to qualify.
Some injuries leave you able to attend work but in a limited capacity. When that limited capacity starts to affect your income, either through lower wages or fewer hours, you qualify for temporary partial incapacity benefits. The benefit amount is less than you would receive for temporary total incapacity benefits, but you can receive it for up to 260 weeks.
When injuries lead to severe enough disabilities to prevent any kind of work, you can qualify for permanent and total incapacity benefits. You will receive 66% of your gross average weekly wage for as long as you are disabled. Minimum and maximum benefit amounts cannot exceed standards set by the state average weekly wage (SAWW) at the time of your injury.
A workers’ compensation claim will often include an injury necessitating medical care. When you receive treatment, you also qualify for medical benefits. A workers’ compensation claim will cover adequate and reasonable medical care, prescription reimbursement, and even mileage reimbursement for travel relating to medical visits. The benefits will last as long as your injuries require treatment for reasonable recovery.
You qualify for scarring and permanent loss of function and disfigurement benefits whenever your work-related injury results in loss of specific bodily functions, scarring on the neck, face, or hands, or disfigurement. This benefit is a one-time payment and is in addition to any other medical benefits you may have received.
When work-related injury leads to the death of an employee, a spouse or child may file a claim for death benefits. Only children who are under the age of eighteen, full-time students, unable to work due to disability and are dependent on the employee may qualify for these benefits. These benefits can cover part or all of the burial costs and a fraction of the lost income, which are distributed among the qualifying spouse and children. Benefits continue so long as the spouse and children remain dependent. If the spouse remarries, eligible children will still receive partial benefits.
Any injured worker may apply for vocational rehabilitation so long as they have an accepted compensation claim, are medically stable, and have permanent functional limitations. The purpose of vocational rehabilitation is to help employees return to their former job or prepare for a new line of work. Employees can request vocational rehabilitation at any point in their claim process.