How Does The Workers’ Comp Claims Process Work?

If you have suffered an injury on the job or contracted an occupational illness from exposure to toxins at work, you may be entitled to receive workers’ compensation benefits. Recovering from a work-related injury can be an arduous process. The Massachusetts workers’ comp system is intended to provide workers with benefits in a timely manner.

The process for filing a claim, however, is complex. Having an experienced workers’ compensation lawyer in your corner during this difficult time can allow you to focus on your recovery. The attorneys at the Law Office of Colonna, Doyle & Simeola in Lynnfield are staunch advocates who can help you navigate the process and obtain the maximum benefits you deserve.

Steps To Obtain The Workers’ Comp Benefits You Deserve

The first steps you need to take after a workplace accident are to inform your employer of your injury and seek medical attention to start your recovery process. It is preferable that you notify your employer in writing, when possible. Massachusetts law expects your employer to notify the Department of Industrial Accidents and the insurance company of your injury.

Your employer has seven days to initiate the workers’ comp claims process after a worker has missed five partial or full days of work due to a workplace injury. If your employer is reluctant (or refuses) to file your claim with the DIA, we can help you to protect your rights. You are entitled to file the claim directly, and we can guide you through the process to ensure that your claim is properly filed.

Once a claim is filed with the DIA, your employer’s workers’ compensation insurance provider has 14 days to accept your claim and issue a check, or to notify you by certified mail that your claim has been denied. The denial must explain the reason for rejecting your claim, a statement outlining the insurance company’s intentions to contest your claim and explain your right to challenge the denial with the DIA.

What Happens To Disputed Claims?

We guide injured workers through the arduous process of filing a claim with the DIA to challenge wrongly denied claims. The DIA uses a three-step process to resolve disputed claims, which includes:

• Conciliation – A conciliator with the DIA meets with the attorney for the insurance company and your workers’ compensation lawyer to determine whether the parties can reach a voluntary settlement to resolve the disputed claim.
• Conference – If conciliation fails, the matter is scheduled for a conference before a DIA administrative law judge. Our lawyers and the attorneys for the insurance provider submit evidence and make legal arguments at the conference for consideration. The judge will issue an order following the conference. If the judge orders the insurance company to pay you workers’ compensation benefits, the order will require the insurance company to also pay your attorney’s fees.
• Hearing – Either party can request a formal hearing within 14 days of the conference order asking the judge to reconsider his or her decision. Additional evidence, including witness testimony and cross-examination are available in the formal hearing.

We are staunch advocates for the rights of injured workers. We will help you pursue your claim to ensure that no mistakes are made during the complicated claims process.

Schedule A Free Consultation

To arrange a free consultation with an experienced workers’ compensation lawyer in, send us an email or call 781-667-2658.