What is Workers Compensation?

Marcotte Law Firm LLC — Mon, 26 Oct 2020 11:51:47 GMT

Most people know that if you were injured at work, you may be eligible for what is known as “Workers’ Compensation.” But, oftentimes, injured workers don’t know what kind of benefits are available, and they don’t always know how to qualify. What is Workers’ Compensation? Workers’ Compensation is a form of insurance that every employer is supposed to have to cover injured employees. While there are many types of benefits available, the two main types of benefits provide wage replacement and medical benefits to employees injured during the course of employment. One of the good things about Workers Comp is that it is supposed to provide you benefits right away. The system was set up this way because when a worker is injured, he/she might not be able to pay rent or put food on the table if they go too long without a paycheck. However, there is a tradeoff for these “quick” benefit. Under the Workers’ Compensation system, the employee forfeits the right to sue his or her employer for negligence. Should I get an attorney for my Workers’ Compensation claim? According to the Commonwealth of Massachusetts, half of all injured worker claims are not disputed by an insurer or employer. This means that you should receive your benefits without having to “put up a fight” with the insurer or employer. If the insurance company agrees to pay the claim without any pushback, you can get your first check in a week or two, and then either weekly or bi-weekly after that. However, this doesn’t mean you don’t need a lawyer. Even in undisputed claims, having Workers Comp attorney can help facilitate the process with the insurer and get you your payments as soon as possible. The attorney can make sure you’re getting the right amount of benefits. Your lawyer will also be able to tell you when it’s best to think about settling your case. In short, Workers’ Compensation can be complicated and having an attorney on your side can help you navigate through these issues. Many people who come see us are not as lucky. The insurance company that’s supposed to pay for your injury denied your claim. If that’s the case, it is a good idea to work with an attorney to protect your rights and interests right away. In these situations, you have to file a claim with the Department of Industrial Accidents (“DIA”), which oversees the Workers’ Compensation system in Massachusetts, and have your case heard in front of an Administrative Law Judge (“ALJ”).Going in front of a judge and getting your benefits can take up to five (5) months, so waiting to hire an attorney is never advised. What does the claim appeal process look like? In the event you and your employer’s Workers’ Compensation insurer can’t agree on your claim, the DIA will help settle the dispute through a four-step process:

Conciliation – A conciliation is an informal meeting between you, your attorney, the insurer’s attorney, and a conciliator from the DIA.
Conference – A conference is where the judge makes an initial determination about your claim. It is still an informal process, despite the ALJ’s presence. At the end of the conference, the ALJ will issue an order.
Hearing – If the conference order is appealed, the case will go to a full evidentiary hearing. This hearing is similar to a trial. Witnesses are called, and a stenographer records testimony.
Reviewing Board – If a hearing decision is appealed, the DIA’s Reviewing Board hears the appeal. Three (3) ALJs will examine the hearing transcripts. The reviewing board has some discretion as to how the review will proceed. They can ask for oral arguments.

They can affirm the hearing decision with no discussion or they can send a decision back to the administrative judge for further findings of fact. The process can be a long one and it can be in your best interest to have an attorney at your side. If you’ve been hurt on the job, it’s important to find an experienced Workers Compensation Attorney quickly so that you can get your benefits as quickly as possible.

What are Social Security Benefits?

Marcotte Law Firm LLC — Fri, 09 Oct 2020 12:18:50 GMT

You may know “someone on disability,” but what does that mean? Many people may not be aware that the Social Security Administration (“SSA”) oversees a program for individuals who are unable to work due to medical impairments. The program is a lifeline for those who are unable to work, mostly through no fault of their own. This includes people who have physical impairments such as a back injury as well as mental impairments like Post Traumatic Stress Disorder (PTSD). At the same time, it doesn’t matter whether your impairment, whether mental or physical, happened at the job. It also doesn’t matter whether your impairment happened suddenly or was something that happened over time. In reality, “Social Security Disability” includes two separate programs: Social Security Disability Insurance (“SSDI”), and its sister program Supplemental Security Income (“SSI”). They are federal programs created to help those in need and who qualify. When someone can’t work, that person still needs a roof over their head and food on the table. These programs are meant to give these injured individuals enough money to provide for their basic needs. Just like Medicare retirement benefits, you receive a monthly payment to pay for your rent and groceries. It might also allow you access to Medicare or Medicaid (Mass Health) to pay for your medical treatment. If you have been unable to work for one year, or have a medical impairment or impairments that are expected to last for more than one (1) year, you may be eligible. Unlike Workers Compensation plans, your impairments do not have to be work-related. In order to qualify, you need to establish that your injuries/impairments make you unable to work. This is usually done through the medical records of your doctors. Your doctors evaluate you,, diagnose you, and recommend treatment plans. The Social Security Administration then looks at those records as evidence of your doctors’ opinions. It then makes a decision based on those opinions. In order to be awarded benefits, SSA applies a 5-Step Sequential Analysis to your claim. At step one, you must establish you are not currently engaging in Substantial Gainful Employment. This means that you’re not working or have not been making more than about $1200 per month within the past year. At step two, you must establish your impairment(s) will last or are expected to last at least 12 months. Many people assume that Social Security Disability benefits are only for permanent injuries. This is not necessarily the case. At step three, SSA must consider whether your impairment(s) “meet or equal” what is known as a “Listing.” These listings include not only your injury, but also your age. Some are tough arguments to make, but depending on the nature and severity of your impairments, they may be available to you. If you are found to meet or equal a Listing, the analysis goes no further, and you are awarded benefits. At step four, you must establish that you are unable to perform your past work. So, if you have a history of construction work, you have to show that you can’t do that anymore. At this step, it doesn’t matter if you can’t do a desk job, as you have no history of doing that At step five, you must establish that your impairments are such that you cannot perform any jobs in the national economy. The SSA will look at your injury, your job history, your education, and your age to determine if there are any jobs for you to do. For example, the older you are, the easier this step is because there are different rules for claimant’s who have reached the age of 50, and even easier rules for those reaching age 55 or higher. This is a very simplified overview of SSDI/SSI. Applying can be complicated, but an experienced attorney can help you navigate that process. At Marcotte Law, we know the system and can help you develop your claim to its fullest potential.

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What is Workers Compensation?

What are Social Security Benefits?