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Workers’ Compensation

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The premise of the workers’ compensation system is relatively simple: If injured at work you are entitled to certain benefits regardless of fault. That is, regardless of the negligence of the employer or employee. The purpose is to provide relatively quick benefits to the injured worker without the need to sue or prove the employer caused the injury. Many work injuries are pure accidents where no one is at fault. In return, the employer is generally immune from suit or paying any other damages. The benefits, however, are limited. In some cases the injured employee may be able to sue some other party (someone other than his employer or co-employees) for causing his/her injury. In those cases, the injured worker would have both a worker’s compensation case as well as a third party negligence action.

Since benefits are limited (see below under benefits), it is important to determine if some other party may also be responsible. The most common third party actions involve defective machines, auto/truck accidents or injuries occurring off the employer premises. Worker’s compensation does not fully compensate an injured worker; there are no payments for damages such as pain and suffering, inability to enjoy or partake in hobbies, home activities or chores, nor does workers’ compensation replace all of one’s lost wages (compensation pays sixty percent, not one hundered percent). Therefore, it is critical to ensure an injured worker receives every single one of the benefits to which he/she is entitled, as well as investigate the potential of other claims or sources of recovery.

Workers’ Compensation Benefits:

Whether you are injured in New Hampshire or Massachusetts, you receive four basic benefits although the benefits differ in some respects.

1. Disability Pay:
You receive sixty percent of your average weekly pay for the period you are out of work. If you return to work part-time or return and earn less because of the injury you receive sixty percent of the difference you earned at the time of the injury and the amount you are able to earn after the injury. There are different ways to determine your average weekly wage, however, it is usually based on a wage schedule for a certain number of weeks leading up to your injury. If you were working two jobs, you may be able to combine both salaries for the purpose of determining your average weekly wage. There is also a limit on the number of weeks one can receive workers’ compensation. Specifics and certain limitations apply and differ between New Hampshire and Massachusetts.

2. Medical Benefits:
You are entitled to have all reasonable and necessary medical expenses paid by the workers’ compensation insurance carrier. There are limits as to which doctors or health providers an injured employee can see and how much the insurance carrier will pay. These differ between New Hampshire and Massachusetts, however, the injured worker should receive completely proper and satisfactory medical care without paying one penny. Also, the injured worker is entitled to mileage reimbursement for travel to and from all medical treatment, as well as complete reimbursement or direct insurance payments for all medication and necessary health aides.

3. Permanency Awards:
If your injury results in a permanent impairment you may be entitled to a permanent impairment award. Not all permanent disabilities or injuries result in a compensable permanent impairment. Both New Hampshire and Massachusetts have set permanency awards for specific permanent impairments. The impairments and percentage of impairments will be assigned by the doctor. The amount of the award is defined by the Workers’ Compensation Statute. The most important thing to know is simply that you may be entitled to this payment. The employer or insurance carrier may not tell you. Therefore, when you reach a point of maximum medical improvement (”as good as you are going to get”), and you are advised that the injury will ”always” be there – it is at that point you want to insure that you receive any permanency award you may be entitled to. It is also important to have the right doctor provide that permanency rating.

4. Vocational Rehabilitation:
In short, if because of your injury you cannot go back to your old job or field of experience, you may be entitled to vocational training or job placement assistance. In some cases, your previous employer may have to provide a job within your restrictions. It is important to know your responsibilities as well as entitlement under the vocational rehabilitation benefit. This can be one of the most confusing and frustrating of the injured worker ”benefits.” It is important to take advantage of this benefit and not have it take advantage of you.

These are the only four benefits you are entitled to – – you want to make sure you receive what is properly due to you. In some cases, it may make sense to settle your claim. Each case is as different as the injured worker. Timing is key in settlement. The insurance company values the case on the amount of the weekly check that they are paying you and how long they may have to pay you. They don’t pay for the pain or the impact the injury had on the individual. The identical injury to one person has a different settlement to another – it is simply based on their individual weekly compensation rate and how long each person may be out of work. Even if you settle a claim – you never give up the medical treatment benefit. Medical expenses will continue to be paid as long as the treatment is related to the work injury and is both a reasonable and necessary expense.

Attorney’s Fees:

All fees must be approved by the New Hampshire Department of Labor or Massachusetts Industrial Accident Board. In short, in New Hampshire we charge if we obtain a benefit for you that you are not receiving. We charge twenty percent of that benefit (for example – if you are denied worker’s compensation and we obtain a favorable decision at the New Hampshire Department of Labor and, suppose you are owed ten weeks of past due compensation – we charge twenty percent of that amount – not twenty percent of future weeks or prospective benefits). If a settlement is desired and we obtain a settlement that the client desires, then we charge twenty percent. In some instances, such as appeal hearings at the New Hampshire Department of Labor, the insurance carrier – not you – pay the fee if the appeal is successful.

In Massachusetts, the insurance carrier pays our fee if successful – the client only pays if we obtain the desired lump sum settlement.

We offer a no cost conference to fully investigate and review the particular circumstances of your work injury, advise you of your rights and can represent you to protect those rights if you so desire.