Workers' compensation insurance is a state-mandated benefit system designed to protect employees who sustain injuries during the course of their employment.
Attorneys at Iannella & Mummolo can assist employees involved in any work-related injury, whether it results from repetitive use of a body part, such as typing on a computer keyboard in an office, or from a single traumatic incident, such as falling from a beam on a construction site.
Employers are required to have workers’ compensation insurance policies which pay for medical bills and lost wages resulting from such injuries, regardless of who is at fault. In exchange for these benefits, however, the injured worker forfeits his/her right to sue his/her employer. Most employers purchase workers' compensation insurance plans from insurance companies specifically designed to provide benefits for their employees. Most states mandate these plans, with the exception of a small number of jurisdictions that allow larger companies to insure themselves. Smaller companies, however, such as those with just a handful of employees, need not purchase such plans.
The goal of workers' compensation insurance is to facilitate the process of allowing the injured employee to return to work as fast as possible without inflicting unnecessary hardship or loss of business on the employer.
Third Parties and Workers' Compensation Law
While injured employees who accept workers' compensation insurance benefits are not permitted to sue their employers, they are entitled to sue negligent third parties who are responsible for their injuries. For example, if an employee sustains an injury on the job while climbing a ladder that suddenly snaps and accepts workers' compensation damages, the employer cannot sue the employer. However, the injured employee can file a claim against the manufacturer of the defective ladder. It should be noted that if the employee wins a personal injury lawsuit against the ladder manufacturer, the workers’ compensation insurer who also paid benefits on the claim is legally entitled to recover a portion of the benefits paid out of the third party settlement or judicial award. The employer may sue the negligent ladder manufacturer, if the employee chooses not to do so, in order to recover some of the funds that the third party would have paid the injured worker.
Types of On-The-Job Injuries That Qualify for Workers' Compensation Insurance Benefits
Workers’ compensation benefits are most often provided to employees who sustain injuries resulting from specific incidents. However, such benefits are not limited to specific accidents that result in physical injury. Illnesses caused by exposure to certain toxic elements or physical injury resulting from repetitive use of a body part may also qualify as eligible grounds for obtaining benefits.
If an employee suffers from a pre-existing physical condition which is worsened by a work-related injury, workers’ compensation benefits will be awarded if the work-injury is the major, but not necessarily predominant, factor for the employee’s disability and need for medical treatment.
While workers’ compensation may cover medical costs and resulting disability from mental or emotional illnesses, such cases are difficult to prove due to their subjective nature. Additionally, mental or emotional illness arising principally from a bona fide personnel action such as a transfer, promotion, demotion or termination is not covered by workers’ compensation benefits unless such action is proved to have been made as an intentional infliction of emotional harm.
Workers' Compensation Laws and Exemptions
Some types of on-the-job injuries may not merit workers' compensation insurance benefits, including:
- Self-inflicted injuries (such as those incurred in a fight between two employees)
- Injuries incurred while an employee is breaking the law (e.g. a delivery worker robbing a receptionist at one of his sites)
- Injuries incurred while the employee is not working
- Injuries incurred while the employee is violating company policy
In addition, some workers are excluded from receiving workers' compensation insurance benefits, including:
- Shop owners
- Farm workers
- Railroad employees
- Maritime workers
- Independent contractors
- Federal government workers
To determine whether you are eligible for workers' compensation, we advise you to speak to your employer and then consult with one of our attorneys who specializes in workers' compensation laws.
What Workers' Compensation Benefits Might I Be Entitled To?
If you have been injured on the job, you may be eligible to receive compensation to cover the following:
- Medical costs
- Indemnity payments up to 60% of your average weekly wage (tax-free)
- Vocational rehabilitation (job training, placement assistance)
Choosing Between Your Own Doctor and the One Provided By Your Employer
Massachusetts law states that a workers’ compensation insurer is entitled to choose a doctor to examine an injured employee after an injury occurs. However, the injured employee has the right to then seek treatment with any other doctor that accepts workers’ compensation insurance.
When visiting any doctor selected by a workers’ compensation insurer, honestly describe exactly how you were injured, its impact on your ability to perform daily activities, and your medical history. Missing one of these appointments or not cooperating with the insurer’s doctor will negatively affect your ability to collect benefits.
It is in your best interest to hire a personal injury attorney who specializes in workers' compensation law if you or a loved one are disabled as a result of your injury or your claim for benefits has been denied. In either case, be sure to save all documents, including any doctor's reports and documents from your employer and workers’ compensation insurer. Please do not hesitate to contact our team of highly qualified legal professionals to learn more about your rights.
For more information, see some helpful tips to make your worker's compensation claim move more smoothly.