What Does Workers’ Comp Cover in Massachusetts?
The workers’ compensation program is administered by the Massachusetts Department of Industrial Relations. All employers in Massachusetts are required to carry workers’ compensation coverage to protect their employees. If you are injured in a workplace accident or learn that you have contracted an occupational illness because of your work conditions, you can file a claim with your employer’s workers’ compensation insurance carrier. This type of insurance offers several different types of workers’ comp benefits that are described below.
Medical Benefits
Employees who are injured or who contract occupational diseases at work can file workers’ compensation claims for medical benefits. These benefits cover the costs of your medical care for your work-related injuries or illness as long as you need treatment for them. Using medical benefits through workers’ compensation is preferable to using your medical insurance to pay for your health care. Unlike health insurance, medical benefits through workers’ compensation cover 100 percent of the cost without copays or deductibles. Some of the types of things that workers’ comp medical benefits cover include the following:
- Medical care
- Prescription costs
- Mileage for traveling to and from medical appointments
Temporary Total Incapacity Benefits
If your work-related injury or illness leaves you temporarily and totally unable to return to your job, you might be entitled to temporary total incapacity benefits. These benefits are available if your injury or illness forces you to miss six or more days. Temporary total incapacity benefits replace 60 percent of your lost wages up to the state’s average weekly wage. You can receive these benefits for up to 156 weeks if you remain unable to return to work during that time.
Temporary Partial Incapacity Benefits
If your injury or illness does not prevent you from working but forces you to work less and earn less, you might be eligible for temporary partial incapacity benefits. These benefits replace a portion of your lost wages and pay up to a maximum of 75 percent of what your total incapacity benefits would be. These benefits are available for a maximum of 260 weeks.
Permanent, Total Incapacity Benefits
If your injury or illness prevents you from returning to any type of job, you might be eligible for permanent and total incapacity benefits. These benefits pay 66 percent of your earnings before your injury up to the maximum state average weekly wage. The minimum you can receive from permanent, total incapacity benefits is 20 percent of the state’s average weekly wage. These benefits continue as long as you remain disabled and unable to work.
Scarring, Disfigurement, or Permanent Loss of Function
If your workplace injuries resulted in scars to your face, hands, or neck, disfigurement, or a permanent loss of a bodily function, you might be entitled to receive a one-time payment in addition to your other workers’ compensation benefits. The amount you might receive will depend on the severity of your scarring, disfigurement, or loss of function and its location.
Vocational Rehabilitation
Vocational rehabilitation benefits are available to any injured employee who has had his or her liability claim accepted by the workers’ compensation insurance company. Vocational rehabilitation helps people with permanent disabilities return to meaningful employment.
Survivors’ Benefits
Certain surviving family members of workers who are killed in workplace accidents can file claims for survivors’ benefits. These benefits pay for their reasonable funeral and burial costs and help by replacing a portion of the wages the deceased worker earned. Surviving spouses and minor children are eligible for these types of benefits. Surviving spouses can receive up to 66 percent of their deceased spouse’s incomes up to the state average weekly wage. These benefits can continue until the surviving spouse remarries. If the surviving spouse does remarry, eligible minor children can receive payments of $60 per week.
What to Do If Your Workers’ Comp Claim Is Denied
It’s important that you can answer the question “What does workers’ comp cover?” However, it’s also critical to understand what to do if your claim is denied. If the insurance carrier denies your claim, you have the right to file an appeal with the Department of Industrial Accidents. Work with an experienced workers’ compensation attorney to ensure you receive the coverage to which you should be entitled. A lawyer at Ellis & Associates can also help to appeal any denial decision and work to recover benefits for you. Contact us today for a free consultation at 800-MR-ELLIS.