How Long Before I Get Paid Workers Compensation Benefits?

How Long Before I Get Paid Workers Compensation Benefits?

This is a hard question to answer.  For many reasons.  

MGL Chapter 152, Section 6 and Section 7, are the sections of the Workers Compensation Act that establish the time frame for both the reporting of injuries, and the commencement of payment of benefits.  

Section 6 provides that an Employer must, with 7 days of receipt of a notice of injury, notify the workers' compensation insurance company.  However, the "injury" must be one which incapacitates the employee for five or more days.  So, right there, they have up to 12 days following an injury to notify their insurance company.

Section 7 then provides that the Insurer must, with 14 days, notify the employee of their intention to start paying benefits, or their intention to deny the claim. 

So, if all goes well, the employee might not know for over 3 weeks following his or her injury as to whether or not they are going to start getting paid.

However, this is no always the case.  There are many reasons and ways by which these times frames get extended.  The employee might not properly report the injury right away,  Or they may not report the injury to the right person.  This gets compounded even further when you're dealing with an uncooperative employer, and they may not notify the insurance company right away.  

The bottom line is that during these early stages of the case, many things can happen to delay the time frames set forth in Sections 6 and 7 of the Workers' Compensation Act.  

What If The Claim Is Denied?

This compounds things even further.  In the even that, following the employee notifying the employer, then the employer notifying the insurer, the insurer issues a notification of denial, a claim must be filed at the Department of Industrial Accidents to get benefits started.  

How Long Does a Claim Take?

Again, this is a hard question to answer.  

Many times, the mere act of filing a claim will get the Insurer to agree to start benefits.  In those situations, payments could be started up in as little as a couple of weeks.  

However, if the Insurer persists on their denial, the claim must go through a certain process.  The process is as follows.  It first gets assigned to a conciliation.  At this event, the attorneys for both the employee and the insurer will meet with a conciliator, where they will explain their positions.  It is the hope at this stage that the parties can come to some sort of agreement.

If, however, an agreement cannot be reached, the case must then proceed to a Conference, in front of one of the Administrative Judges at the Department of Industrial Accidents.  Conferences can take place in as little as 4 weeks post conciliation.  Sometimes, however, they can take up to 3 plus months to get scheduled.  It is the goal at the Conferences to get the Judge to Order payments to begin.  

However, again, this is not always the case, as sometimes the Judge will deny the claim for various reasons.  This necessitates and appeal, which can delay the process even longer.  

Summation

The point of this is not to discourage potential claimants.  It is simply to make them aware that the process is not always quick.  Quite often, it can be several months before payments get initiated.  This creates a very stressful period for the injured Employee.

What To Do?

The most important thing a worker can do following an injury at work is to contact an experienced Massachusetts workers' comp lawyer right away.  An experienced comp attorney can help guide you through this process and hopefully facilitate the quick payment of benefits, an minimize any delay.

At Troupe Law Office, we have close to 50 years of experienced representing injured workers and their families.  Call us any time for a free consultation.    

For more information, visit our Workers Compensation page, or our Frequently Asked Questions page.