The Claim Process

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Workers' Compensation Claims in Massachusetts

Providing Legal Assistance in Burlington, MA

With offices in Burlington, Boston and Methuen, our team at DiBella Law Offices, P.C. is here to help you with every step of what can be a complicated workers' compensation claim system. From ensuring your employer properly submits a claim to its insurer to helping you prepare for the DIA process and any appeals, we are here to handle every technical aspect so you can focus on your recovery.

The Claims Process

It is important to speak to an attorney as soon as possible after being injured on the job to ensure that your workers’ compensation claim is filed as quickly and accurately as possible so you can receive your benefits. Before filing a workers’ compensation claim, you will need:

  • The date of injury, illness, or death if a dependent is filing for benefits
  • The 1st and 5th calendar day of work missed
  • Name of the workers’ compensation insurance carrier
  • Type of injury
  • Type of benefits being applied for (an attorney can help clarify which)
  • How long you will be unable to work
  • Date treatment was first sought
  • Current doctor treating the condition or injury

Of these, the name of the insurance carrier, the type of benefits being sought, and the 1st and 5th day of disability are the most important. When this particular information is not filled out correctly, claims are often denied.

Injured employees also need to fill out a Form 110 and attach at least one of the following:

  • Unpaid medical bills
  • Medical documentation regarding the condition or injury
  • Any reports from the employer, hospital, or other indicating how the accident happened
  • Names and statements from witnesses

One copy of Form 110 will need to be sent to the employer’s workers’ compensation carrier by certified mail. Medical reports, bills, and other supporting documentation for the claim will also need to be sent to the insurer, even if you believe they already have copies. When these documents are not sent, an attorney for the insurance company will ask to have the claim withdrawn because it was not filed correctly.

It can be impossible for workers to ensure all of the forms are filled out accurately, particularly when trying to recover from a serious injury. But having your own workers’ compensation lawyer eliminates this problem. Plus, your lawyer will deal with the insurance company if it tries to fight the claim.

Conciliation Meetings

A conciliation meeting is an informal meeting between the insurance company, the employer, and the injured worker. These meetings happen in all workers’ comp claims, although the employer is not always asked to attend. But a representative from the insurance company is certainly going to be there, as will the insurance company’s lawyer. They may try to show that the injury is not valid, or that it is not as serious as the worker is claiming. That’s one more reason you need your own lawyer to get you the full benefits you’re entitled to.

For a free initial consultation to discuss your legal goals and the workers' compensation claims process, contact our firm today by calling (781) 262-3338.

Voluntary Payments: the 14-Day Rule

An insurer (or self-insured employer) who fails to act within 14 days faces several possible penalties. It is also illegal for an employer to discriminate against an employee for filing a compensation claim, collecting benefits or testifying at DIA hearings. First, your employer's workers' compensation insurer has 14 calendar days after receiving the first report from the DIA to decide on one of two courses of action.

The insurer must either:

  • Send you a notice of acceptance and a first compensation check
  • Send a notice of rejection by certified mail to you, your employer and the DIA.

The denied claims notice must contain the following information:

  • An exact statement of the reasons for rejection
  • A statement of the insurer's intention to contest any claim by you
  • A statement advising you of your right to file a claim for benefits with the DIA

Filing a Workers' Compensation Claim with the DIA

If your claim is rejected by the insurer, our experienced Massachusetts workers' compensation lawyer can help you can file a claim with the DIA in Boston. You must wait 30 days from the date of injury or enclose a copy of the insurer's notification of denial in order to submit the claim. As you can see, workers' compensation claims are not a simple procedure and should be trusted to a lawyer from our firm where we have more than 10 years of experience.

Contact us today at (781) 262-3338 to schedule an evaluation to discuss your situation with our compassionate and skilled team.