When you are injured on the job, taking time off work is often necessary. Your doctor may recommend going on workers’ compensation until you are ready to go back and there is safe and appropriate work available. In the meantime, you have to pay your bills and take care of your family. Replacement wage benefits are intended to provide financial support during your recovery.
Every employer in Massachusetts is required to carry workers’ compensation insurance. When you are injured and put in a claim for benefits, you will be paid by the insurer, not your employer. The insurer, however, must comply with certain legal guidelines.
Start of Benefits
You will get your first wage replacement benefit checks within three to four weeks. You will only receive payment for the first five days of your time off work if you are away from the job for at least three weeks (21 calendar days or more).
However, just because you start receiving checks does not mean the insurer has agreed to your claim. The company has six months to choose to reduce your benefits or to deny your claim altogether. In some instances, they may ask you to extend this period up to one year. You do not have to agree to this.
Your doctor, attorney, employer and insurer’s doctor will all have a say as to when you are ready to go back to work. In the event you must stay on workers’ compensation, you may receive benefits for up to three years.
Amount of Benefits
Replacement wage benefits are calculated based on your previous income. You can receive up to 60 percent of your previous wages if you are entirely unable to work. This is subject to the minimum and maximum weekly wage benefits set by the state of Massachusetts, which change every year. As of October, 2016, the minimum weekly benefit is $258.35 and the maximum $1,291.74.
Replacement wage benefits do not include other reimbursements you may receive. You can get money for medical bills and, in the case of some serious injuries, other damages.
If the Insurer Denies Your Claim
Even if the insurance company has been paying benefits, it may suddenly decide to deny your claim or pay you less money. The company is required to send you Form 104, “Insurer’s Notification of Denial.” However, if the company decides to take this step, you still have options.
At any point during your workers’ compensation claim, you can get assistance from an attorney. You may appeal a denial, reduction in benefits, or being pushed to go back to work too early. To learn more, contact Konstantilakis Law P.C.