Canton Workers' Compensation

Major employers in Canton include Reebok, One Beacon, Boston Mutual Life Insurance Company, and Dunkin Brands. The median income for a family there is about $80,000. As in other Massachusetts cities, many residents suffer from a job-related injury or illness at some point. When this happens, they may be eligible for workers' compensation benefits. However, in many cases, insurers partially or fully deny legitimate claimants the benefits they deserve. Some workers assume that the insurers' grounds are the last word, or that the denial is from the state. However, a denial may be issued for numerous reasons that may be challenged on appeal. You can consult an experienced Canton workers' compensation lawyer at Pulgini & Norton if you are pursuing benefits or appealing a denial.

You should report your injury to your employer right away. If you have been disabled for five partial or full days, the employer is required to notify the insurer of your injury or illness. The insurer makes a decision about whether to accept or deny your claim. You may receive benefits right away, but you should not take this as an acceptance of liability. An insurer can pay benefits for a maximum of 180 days, known as a pay without prejudice period, without accepting liability. The insurer need give you only seven days’ notice of its decision to terminate benefits. In some cases, the insurer may ask you to extend the pay without prejudice period for more than 180 days. You should consult an attorney before agreeing to this.

An insurer must send you a copy of Form 104 (Notification of Denial) by certified mail if it is denying your claim. The form will detail why the insurer is partially or fully denying your claim. You have the right to appeal both partial and full denials of your claim.

Although Form 104 includes instructions on how to appeal the denial and the time frame within which to appeal, you should consult an attorney if you receive a Notification of Denial. The insurer will have experienced attorneys representing its interests, and it is important to remain on an equal footing by having an attorney of your own.

To appeal a denial, you would need to file Form 110 with the Department of Industrial Accidents (DIA), which administers the workers' compensation law in Massachusetts, and send a copy to the insurer. Form 110 initiates the dispute resolution process that allows you to obtain a decision from an administrative law judge about the benefits to which you may be entitled. Form 110 will ask you not only about your injury but also about the type of compensation you are seeking. You would have to provide documentation about your claim, including medical records and bills incurred to date.

After a copy of Form 110 is submitted, the DIA will schedule conciliation, which is the first stage of the appeals process. Conciliation is an informal meeting at which the insurer, its attorneys, you, and your attorneys can try to reach an informal agreement about what benefits you should receive. There are four more steps in the appeals process within the DIA.

If you have endured a job-related injury or illness, you may be stressed and anxious about how you can take time off work or pay your medical bills. Although the workers' compensation system was intended to make the process of receiving benefits smoother, it is not uncommon for insurers to unfairly deny the claims of employees. A workplace accident attorney in Canton or the surrounding area can help you fight for the benefits to which you may be entitled. Call Pulgini & Norton at 781-843-2200 or contact us via our online form for a free consultation.