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Workers Comp in Massachusetts

If you are a small business owner in Massachusetts, you’ll need to get a workers compensation insurance policy. Workers compensation helps protect you and your employees if they get injured or sick from a work-related activity. It helps pay for medical treatment, compensation for lost wages, or even disability. The state of MA requires business owners to get workers compensation for their employees, and yourself (if you are an employee) regardless of the amount of hours your employees work.

 

What constitutes a work-related injury or illness?

If an employee gets hurt or sick on the job, their injury or sickness must last more than 5 calendar days. If it does not last long, it’s considered “medical-only” and a claim cannot be made.

 

What happens if I don’t have workers comp coverage?

If you do not have workers comp, you could be issued a STOP WORK order. This will halt all business activities until you have active workers comp. You could also be subject to fines of a minimum of $100. You could also have potential jail time and a fine of us to $1500 at the time of conviction. It’s important to have workers comp to avoid all theses charges, and to keep your employees protected!

 

What happens if a employee gets injured on the job?

If one of your employees suffers a work-related injury, they should file a claim. Once they do so, you have seven days to fill out the Employer’s First Report of Injury/Fatality (Form 101), which can be done online. Once you complete the form, print out three copies: one for employee, one for insurance, and one for you. Hopefully, this will never happen to one of your employees, but if it does, it’s a good idea to know the procedure!

 

This is the process of filing workers comp:

  1. Injury or Illness occurs

The injury or illness must last for more than five days. Once this happens, you, the business owner, must fill out the Employer’s First Report of Injury/Fatality (Form 101) and send it to the employee and the insurance company. This form should be filled out 7 days after the 5th day of injury/illness

  1. Payment or Denial of the Claim

Once the insurance company receives the claim, they can either accept or deny it. They have 14 days to make a decision on whether they are paying benefits to the injured/sick employee, or if they are denying the claim. If there are any contested claims, there would be a conciliation.

  1. Conciliation

If there is a contested claim, then this is when conciliation happens. It’s an informal meeting between your employee and your insurance company. They sit down and try to reach a settlement. You, the business owner, usually do not need to go to this meeting. If a settlement cannot be reached, then the claim moves to a conference, which is step 2 of the dispute resolution process.

  1. Conference

A conference is an informal proceeding before a judge. The inured/sick employee must be present. As a business owner, you are only obligated to go if there is a willful misconduct by the employer. At the conference, the employee must show that they are:
a. Disabled
b. The injury or illness was work-related
c. The disputed medical bills were for reasonable and necessary treatment

The judge will then make a decision from the evidence. If either party, or employee thinks that the judge has made a mistake, they can make file an appeal.

  1. Hearing

This is similar to a conference, but a hearing is a formal proceeding. At a hearing, both the employee and insurance company must be present. The employee, again, must only attend if the claim involves Wilful Misconduct of Employer. Once the judge issues a decision, there is a 30 period where an appeal can be made. If a hearing is appealed, then it moves onto a reviewing board.

  1. Reviewing Board

A board of 6 judges will sit and listen to the augments of either party. They can reverse, or uphold, the decision of the judge.

Keep in mind that a workers comp claim may not actually proceed through all these steps. Usually, a settlement can be made.

 

The best thing to do is take measures to prevent an injury or illness from occurring! Check out these workers comp tips to prevent a workers comp claim. Keeping your employees safe on the job should be one of your priorities! Talk to your insurance agent to make sure you have a workers comp policy and that you are prepared to deal with any workplace mishaps!

 

Call an Encharter agent at 888.754.8299 to address any questions or concerns you have about workers comp!

 

Additional Sources:

https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXXI/Chapter152

http://www.mass.gov/lwd/workers-compensation/publications/employers-guide/er-guide-english.pdf

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