Workers' compensation is an important program that protects employees in work-related accidents or illnesses. Like every other state in the US, Massachusetts has its own workers' compensation system. This article will give employers an overview of Massachusetts workers' compensation, including its purpose, coverage, benefits, and claims and responsibilities.
The basic goal of the workers' compensation system is to give financial aid and support to employees who suffer work-related injuries or illnesses. It assures injured workers receive proper medical care, salary replacement, and rehabilitation services while shielding businesses from future workplace accident litigation.
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Workers' Compensation Coverage in Massachusetts
The workers' compensation system in Massachusetts covers the majority of employees, including full-time, part-time, and seasonal workers. This criterion applies regardless of the number of hours worked in any given week, except for domestic service employees, who must work at least 16 hours per week to be covered. The only exceptions are domestic workers, select agricultural workers and federal personnel.
Independent contractors are normally ineligible for workers ' compensation benefits unless they are considered "statutory employees" under Massachusetts law.
Certain corporate officers may seek exemption from workers' compensation coverage. Any corporate official holding at least a 25% stake in the company is exempt from the workers' compensation legislation restrictions. Employees of a corporation who are not listed as corporate officers are NOT eligible for this exemption. All employees must always be insured by valid workers' compensation coverage.
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Workers' Compensation Benefits in Massachusetts
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Under Massachusetts law, qualifying employees are entitled to a variety of benefits, including:
- Medical Benefits: Injured workers have the right to reasonable and necessary medical treatment for work-related injuries or illnesses. Doctor visits, surgeries, hospitalization, prescription drugs, and rehabilitative treatments are all included.
- Wage Replacement: Employees who cannot work due to a work-related injury or sickness may be eligible for temporary complete disability compensation. Subject to specific maximum and minimum constraints, these benefits normally amount to two-thirds of the worker's average weekly pay.
- Benefits for Permanent Impairment: If an employee experiences a permanent impairment or loss of function due to a work-related injury, they may be entitled to further compensation depending on the kind and extent of the impairment.
- Vocational Rehabilitation: In circumstances where an employee cannot return to their previous job due to an injury or illness, vocational rehabilitation assistance may be provided to aid the worker in obtaining acceptable employment.
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Workers' compensation death benefits in Massachusetts
Some family members may be eligible for death benefits if an employee dies due to a work-related injury or disease. Weekly payments to cover a percentage of the deceased employee's income and funeral and burial expenditures are among them. Eligible family members include:
- The surviving spouse or child of a deceased employee who died due to a work-related injury or illness.
- Children are only eligible if they are under 18, enrolled full-time in school, or cannot work due to physical or mental disability.
Dependent family members of the dead worker will get death benefits calculated based on the person's pre-injury weekly wage. Surviving spouses are eligible for weekly payments equal to 66% of the deceased worker's average weekly earnings but not more than the state average weekly wage (SAWW) at the time of death.
Once two years have passed since the worker's death, spouses are eligible for yearly cost-of-living adjustments (COLAs). If a spouse remarries, the offspring of the deceased worker will get $60 per week, not to exceed the spousal benefit.
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Employer Responsibilities
Employers in Massachusetts have certain workers' compensation requirements, which include:
- Insurance: Most businesses are obliged to have workers' compensation insurance. They can receive coverage from a private insurance company or gain self-insurance if they meet specific criteria.
- Employers must notify their employees about their workers' compensation rights and benefits by posting the "Workers' Compensation Posting Notice" in a prominent position at the workplace.
Employers are responsible for promptly reporting workplace injuries or illnesses to their insurance carriers. They must also cooperate with the injured employee and the workers' compensation system throughout the claims procedure.
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Filing a Claim
To file a claim for workers' compensation payments, employees must be disabled for 5 full or partial calendar days. The days do not need to be consecutive. Employees have four years from the date of injury or realization that their injury or sickness is work-related to make a claim. Employees can file a "medical only" claim if they are handicapped for less than 5 full or half calendar days. Medical claims are reported to the employer's workers' compensation insurer rather than the DIA.
If your insurer declines your claim for benefits, even if it is merely for medical reasons, you can appeal to the DIA. To begin a workers' compensation claim in Massachusetts, the injured employee must tell you, the employer, as soon as possible, ideally within 30 days, of the accident or illness. The employer is then accountable for notifying their workers' compensation insurance company of the incident. It is critical to disclose the injury immediately to ensure the claim procedure runs properly.
Employers are required to electronically file the Employer's First Report of Injury/Fatality. The Department of Industrial Accidents (DIA) has processes for electronically filing forms using a log-in and password. To sign up for an account, go to https://www.mass.gov/how-to/apply-for-a-dia-online-account and register.
When you have finished filling out the form, click the print option to get a hard copy. Make three copies of this form: 1 copy must be delivered to the employee, 1 copy must be given to your insurance company, and 1 copy must be kept for your records.
Dispute Resolution
If a dispute or disagreement arises about a workers' compensation claim, there are numerous options for resolution. Mediation, conciliation, and formal hearings before the Department of Industrial Accidents (DIA) are all examples of this. If required, appeals can be taken to the Massachusetts Workers' Compensation Reviewing Board and, ultimately, the court system.
What are the consequences of not having workers' compensation in Massachusetts?
If you operate your business without workers' compensation insurance, you may face harsh penalties in Massachusetts. If you do not provide workers' compensation insurance as state law requires, the state may issue a Stop-Work Order (SWO). You will no longer be permitted to conduct business in the state.
Furthermore, you may incur a minimum daily penalty, including weekends and holidays, for each day you fail to provide coverage. Your penalty will grow until you provide insurance and pay your fine. If you do not appeal the SWO, you must close until you offer workers' compensation coverage and pay your fine.
If you opt to appeal the SWO, you can keep your business open, but your daily fine will increase. Finally, any Massachusetts employer that is not covered cannot compete for public contracts.
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Conclusion
Massachusetts' workers' compensation system covers most employees, including full-time, part-time, and seasonal workers. Under Massachusetts law, qualifying employees are entitled to a variety of benefits. Employees must file a claim for workers' compensation payments after being disabled for 5 or partial days, with four years from injury or sickness realization. Massachusetts businesses without workers' compensation insurance face harsh penalties, including a Stop-Work Order, preventing business operations and imposing penalties. Thus, employers in Massachusetts must ensure that they provide this insurance for their employees and support employees when injured whilst performing their duties.