When Can I Make a Workers’ Compensation Claim?

If you incur injury from a workplace incident, your employer’s workers’ compensation insurance should cover your medical expenses and potential loss of wages. While many employees understand they have a right to these benefits, many do not know the process for completing a claim. Calling a workers’ compensation lawyer and knowing how to file a claim is just as important as knowing when you can do it.

Injuries Eligible for Workers’ Compensation

Because of workers’ compensation functions on a no-fault basis, you should receive coverage even if your injuries were not the fault of your employer. This means most injuries that occur at the workplace are eligible for workers’ compensation benefits, though some exceptions exist for accidents involving horseplay or employee misconduct.

Potential benefits can include payments for temporary or permeant wage loss, reasonable and necessary medical care, and training for a new line of work if the extent of your injuries prevents you from returning to your current line of work.

Reporting Your Injury

As soon as possible after your accident, report your injury to your employer. Do this either through verbal or written notice, though written notice creates a record that you fulfilled the proper reporting requirements. If you only discuss it verbally, make a note of the date and time.

Under Massachusetts workers’ compensation law, you may lose your right to benefits if you do not report your injury promptly. To insurance companies, a delayed notice often raises suspicion of falsified injuries, which can lead to claim denial.

Most often, your employer will also have you fill out a written accident report. Both your notice of injury and any accident reports will cover when and where your injury occurred, as well as any symptoms you may be experiencing. As workers’ compensation may have restrictions on where you can receive treatment, your employer will inform you of the doctors in the network eligible to provide medical treatment.

Reporting your injury will often be enough to start your workers’ compensation claim. Your employer will take steps to file the Employer’s First Report of Injury or Fatality with its insurance company and the Massachusetts Department of Industrial Accidents (DIA). If the company covers your injuries, you do not need to take any further steps.

Filing Your Own Claim

While your employer should take steps to file the necessary reports of injury, you will need to file your own claim if your employer refuses. Likewise, you will also need to file your own claim if your employer’s insurer denies the initial claim. You should receive notice within a few weeks after your employer files. In both cases, you will need to fill out an Employee’s Claim (Form 110) and submit it to the DIA to begin the process.

To file a claim with the DIA, you will need to know:

  • Your date of injury, illness, or death (where applicable)
  • The first and fifth calendar days of work you missed
  • The name of the workers’ compensation insurance carrier
  • The types and locations of injuries
  • The type of benefits you’re seeking
  • The time frame you may be away from work
  • Where you initially received treatment
  • Your current physician

You will also need to submit any unpaid medical bills, medical and accident reports, and witness names and statements to support your case. Improper filing can result in claim denial, so you should take care to follow all state instructions.

Time Frame for Filing

You have four years from the date of injury, awareness of injury, or reception of Insurer’s Notice of Denial to file your claim. However, it is best to act sooner rather than later, especially in cases where your employer has refused to file for you.