Workers’ compensation is unlike other areas of the law. While you will understand the common meanings of many words used in the course of your claim, some words and phrases have specific meanings when they are used in the workers’ compensation context.
In order to protect your rights and make sure that you get the benefits that you deserve after a Massachusetts work injury, it is important to understand the specific meaning of workers’ compensation terms that could impact your recovery.
Workers’ Compensation Terms Defined
Some of the terms you need to know include:
- Average weekly wage. This is the sum of your total gross earnings (including things like overtime and bonuses) for the 52 weeks prior to your injury divided by 52. This gives you your average weekly wage for workers’ compensation purposes.
- Conciliation. Conciliation is the first stage of the workers’ compensation dispute resolution process. This is an informal meeting between you (or your lawyer), the insurance company, and the Department of Industrial Accidents (DIA) to try to reach a voluntary agreement about your claim.
- Conference. A conference is the second stage of a workers’ comp appeal. A conference will happen if an agreement cannot be reached at the conciliation stage of dispute resolution. It is still an informal proceeding, but it is with an administrative law judge. No witnesses may be called. The administrative law judge will issue an order after the conference.
- Impartial medical exam. The DIA requests and pays for your impartial medical exam by a doctor other than your own. The DIA will decide who your doctor will be, based on a list that it maintains, and the doctor who performs the impartial medical exam may serve as a witness for the judge.
- Independent medical exam. Unlike an impartial medical exam, the insurer requests and pays for a medical exam by a doctor other than your own if it calls for an independent medical exam. The insurer may require that you see a doctor of its choosing.
- Medical benefits. Medical benefits are adequate and reasonable health care services to diagnose and treat your injuries. Additionally, medical benefits should include compensation for your travel to and from medical appointments.
- Pay without prejudice. A workers’ compensation insurer may pay your benefits for up to 180 days before making a final determination about your workers’ comp claim. During this time, which may be extended with your consent, the insurance company is not accepting liability. The insurer can stop or reduce your payments during this time if it gives you at least seven days written notice.
- Temporary total incapacity. You have a temporary total incapacity if you are unable to work for five or more days. These days may be whole days or partial days and they need not be consecutive.
- Partial incapacity. You have a partial incapacity if you are unable to work the same number of hours or a job for the same pay that you did prior to your work-related injury.
- Permanent and total incapacity. You have a permanent and total incapacity if you are unable to do work for any kind.
- Work-related injury: A work-related injury or illness is one that occurs in the course of your employment.
Of course, this list is not all-inclusive and there are other terms that could be important to your recovery.
Talk to Your Workers’ Compensation Lawyer to Make Sure Your Rights are Protected
Your workers’ comp attorney will make sure that you know what the terms mean and that you know how to protect your rights. The workers’ compensation insurance company may not do the same. Accordingly, in order to protect your rights, it is important to have an experienced workers’ compensation lawyer working for you.
From the time that you first file a workers’ comp claim, through any necessary appeals, and until your workers’ comp benefits are supposed to legally end, your lawyer can make sure that your rights are protected. To learn more about how to protect your rights after a workplace injury in Massachusetts, please contact the lawyers at Keefe Disability Law to schedule a free, no-obligation consultation. We can be reached via this website, by phone, or by email and we would be pleased to welcome you in our Natick office at the time of your appointment.