If you become incapacitated as a result of work in the Commonwealth of Massachusetts, you may be entitled to certain disability benefits. Depending on the nature of your disability, these benefits range from temporary to permanent and partial to total. Knowing the differences can help you get the best coverage allowed by workers’ compensation laws.
Temporary Total Incapacity Benefits
You qualify for this benefit if your illness or injury leaves you temporarily unable to work for six or more full or partial calendar days (not necessarily consecutive). For example, you may need knee surgery and physical therapy that will incapacitate you for a period of time.
Your benefit will be 60% of your gross average weekly wage based on the prior 52 weeks of your employment – up to a maximum of the state’s average weekly wage (SAWW) at the time of your injury.
You may potentially receive this benefit for up to 156 weeks (three years).
Temporary Partial Incapacity Benefits
You qualify for this benefit if you are able to work but are forced to take a lower paying job or work fewer hours, resulting in fewer earnings.
Your benefit will be 60% of the difference between your pre-injury wage and post-injury wage. The wage is calculated as your gross average weekly wage.
For example, if you earned $1,000 before your injury and $600 after it, you would be losing $400. The benefit would pay 60% of this difference or $240.
However, there is a cap on the amount of partial disability that you can receive. The most you could receive with temporary partial is 75% of your temporary total benefit.
You may receive this benefit up to 208 weeks (four years) or up to 260 weeks (five years). This depends on how much temporary total disability you have received.
Permanent and Total Incapacity Benefits
You qualify for this benefit if you are totally and permanently unable to perform any kind of work on the open market as a result of your illness or injury. Permanence is defined as “for the foreseeable future.”
This determination will be made on the basis of age, education, work experience, and medical condition.
Your benefit will be 66% of your gross average weekly wage, with a minimum of 20% of the state average weekly wage (SAWW) and a maximum of the SAWW. You also receive annual cost-of-living adjustments (COLA).
You can receive this benefit for as long as you are disabled.
You qualify for medical benefits if you suffer a work-related injury or illness that requires medical attention.
The benefits are adequate and reasonable medical care, prescription and mileage reimbursement for travel to and from medical visits.
Your employer has the right to send you to the doctor or hospital of their choice for the first medical visit. You have the right to choose your own healthcare provider for subsequent visits.
The insurance carrier has the right to send you periodically to see its doctor for evaluations and may deny or stop treatments it believes are not reasonable or necessary. But, you can appeal this denial.
Contact Eden Rafferty for Assistance
Workers’ compensation laws are complicated and often require skillful negotiations to receive the maximum benefits possible. If you have become injured or ill at work, contact the offices of Eden Rafferty and talk to one our attorneys experienced in negotiating the best workers’ compensation benefits for our clients.