What Is Workers Comp And What Does It Do?

What Is Workers Comp And What Does It Do?

Essentially, workers compensation insurance, or, simply, workers comp, is an insurance policy that every Employer in Massachusetts is required to carry. It’s the law. They have to carry it, and they are subject to penalties if they don’t.

The policy is their for the benefit of the Employees. Every employee is covered.

When and how does it work?

Simple. If an employee sustains a work related injury and is unable to work and/or needs treatment related to the injury, the policy kicks in.

It is important to note that a work injury can be a physical injury, such as if an employee falls from a ladder and breaks his or her leg. It can also be an emotional/psychological injury, such as a prison guard who is assaulted on the job and now suffers from PTSD. The injury can also be the result of an exposure to a toxic substance, such as asbestos.

What benefits does it provide?

The two main benefits are 1) weekly disability checks while the employee is unable to work, and 2) medical benefits related to the injury.

Disability payments can come in 3 forms:

• Section 34 – Temporary Total Disability
• Section 35 – Temporary Partial Disability
• Section 34A – Permanent and Total Disability

The type of benefit due depends on a number of factors. For more information, see our Types of Benefits page.

A typical example of a garden variety work injury is a carpenter who picks up a heavy piece of equipment and suffers a low back injury. This injury results in him being unable to do his job, forcing him to go out of work. He also needs to undergo medical treatment to fix his injury. If all goes well, the Employee will received Section 34, temporary total disability benefits while he is out of work. This means he will receive a weekly check that amounts to 60% of his gross wages while he it out of work. Further, his medical treatment will be paid by the workers comp insurer as well. He will incur no out of pocket costs and can even be reimbursed for mileage. After a few months, he is back to his pre-injury status and returns to work full time. At this point, his weekly checks stop.

That is generally what the system is designed to do. Pay the injured worker while he’s out of work, and pay for his medical treatment so that he’s able to return to work as soon as possible.

Sounds simple. But it is very often anything but.

Workers Compensation insurance companies are difficult to deal with. Sometimes, even the employer is difficult to deal with. In situations like this, they may cause many problems. They may say that the injury didn’t happen at work, so you’re not entitled to benefits. They may deny payments altogether. They may say that you don’t need medications, physical therapy, and MRI, or surgery. This results in delays in treatments. They may say that you’re ready to return to work when your doctor is saying you’re not.

The bottom line is that this process can be extremely complicated. It can get messy too.

This is why it is absolutely essential to have an experienced workers comp attorney at your side from the outset.

At Troupe Law Office, we have over 50 years of experience, solely in the representation of injured workers and their families. Call us any time for a free consultation.