How do I know whether I am covered by workers' compensation?

Who pays for workers compensation benefits?

What types of injuries are covered by Worker's Compensation?

My supervisor says that I can’t get workers’ compensation because it
     was my fault that I got hurt. Is this correct?

What monetary benefits are available if I become disabled?

What medical coverage will I receive if I am injured at work?

What are my rights if my injury is caused by the negligence of
     someone other than my employer or co-worker?

When I suffer a work injury do I have to treat with the company
     doctor?

The employer's doctor releases me to go back to work but my doctor
     disagrees. What are my rights?

Is workers' compensation the same as State Disability?

How do I know whether I am covered by workers' compensation?
Generally, there are two main factors that determine your status: first, whether you are an employee, and second, whether your injury occurred as a result of your employment.

Who pays for workers compensation benefits?
The employer pays the cost of the workers’ compensation benefits for injured employees or their families. Most employers have insurance that covers the cost of providing injured employees with workers' compensation benefits. In Massachusetts, an injured employee may bring a personal injury action under Tort Law in the Civil Courts against an employer who did not have workers compensation insurance when the employee was injured.

What types of injuries are covered by Worker's Compensation?
Any injury that arises out of and in the course of employment is compensable. If an injury occurs at work regardless of who is at fault, it will generally be covered unless the injured person is guilty of serious and willful misconduct. Employees who become disabled due to repetitive activities such as lifting are entitled to benefits under the law. In addition, cumulative trauma/repetitive motion injuries such as carpal tunnel syndrome and tendonitis are covered.

My supervisor says that I can’t get workers’ compensation because it was my fault that I got hurt. Is this correct?
No, it doesn’t make any difference whose fault it was. In most cases, unless you were intoxicated when you were hurt, hurt yourself on purpose or while you were horsing around, or were hurt by someone who was mad at you for personal reasons, you are entitled to weekly payments and medical benefits for your injury.

What monetary benefits are available if I become disabled?
If a worker is totally disabled due to an industrial injury, then he receives 60% of his pre-injury wage, which is based on an average of gross earnings prior to the injury. These benefits can last for a maximum of three years. If the worker is partially disabled (unable to do regular work and/or earn regular pay) then the insurer must pay 60% of the difference between the pre-injury wage and the worker's earnings. These benefits can last for a maximum of five years. Combined a worker can collect total disability and partial disability for a maximum of seven years.

What medical coverage will I receive if I am injured at work?
An injured worker is entitled to full payment for all medical treatment that is reasonable, necessary and related to the accident. There are certain guidelines that may restrict an employee's treatment however; workers will generally be able to obtain treatment. If they request, your employer can have you seen by its doctor as well.

What are my rights if my injury is caused by the negligence of someone other than my employer or co-worker?
If you are injured due to the negligence of a third party, that is someone other than your employer or a co-worker, then you may have the right to bring a civil lawsuit against that third party. Your right to bring a claim against the third party does not affect your right to receive worker's compensation benefits. The benefits available in a third party claim include the right to collect for lost wages, pain and suffering, medical costs and spousal rights.

When I suffer a work injury do I have to treat with the company doctor?
For the first 90 days of medical care, the law requires you to select from a list of doctors chosen by your employer. The law says that there must be at least six doctors for you to choose from. Your employer cannot (and should not) make the choice for you. You are free to choose your own doctor if your employer does not have a list available. And you are free to select another doctor on the list if the first choice was unsatisfactory. The list usually appears on letterhead from the workers' compensation insurance carrier. The sheet should explain your rights and obligations under the law.

The employer's doctor releases me to go back to work but my doctor disagrees. What are my rights?
You can choose not to go back to work, but if you do not return to work the insurance company will probably file a petition to terminate, suspend or modify benefits. In this case you will continue to receive benefits until a hearing is scheduled for a judge to review your claim.

Is workers' compensation the same as State Disability?
No. Workers' compensation is only for injuries or illnesses that occur due to employment. State Disability is for injuries or illnesses that are not work related and is handled by the Employment Development Department.

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