What types of workers compensation benefits are awarded?

Massachusetts’ workers are entitled to compensation if they suffer a work-related injury or illness. Workers eligible for workers’ compensation may be entitled to different types of benefits depending on their injury, ability to work and other factors.

Temporary total incapacity

These temporary benefits are awarded to workers if their injury or illness prevents them from working for at least six partial calendar days which do not have to be consecutive. The worker’s age, training and experience are reviewed.

Benefits constitute 60 percent of the gross average weekly wage. The benefit calculation involves:

  • Determining actual gross earnings including any overtime and bonuses.
  • Dividing those wages by the number of weeks worked at the job which determines the average weekly wage.
  • Multiplying that number by 60 percent.

The maximum wage is the state average weekly wage, set by the Massachusetts Division of Unemployment, on the date of the injury. Benefits begin on the sixth day of incapacity and may last up to 156 weeks. There is no compensation for the first five days of capacity unless the disability lasts for at least 21 calendar days.

Partial incapacity

Workers qualify for these benefits if their injury or illness reduces part of their ability to earn a living. Injured workers may also receive these benefits if they must take a job at lower pay or work fewer hours.

The maximum compensation is restricted to 75 percent of what the workers’ compensation would be. Workers may receive these benefits for up to 260 weeks.

Permanent and total incapacity

Injured workers are eligible for these benefits if they are unable to engage in any work because of their injury or illness. Claimants can seek permanent benefits before their temporary benefits end. Benefits continue for as long as the worker is disabled.

Claimants receive two-thirds of their average weekly wage or a minimum of 20 percent of the SAWW based on their 52 weeks before they were injured which may be up to the SAWW maximum. Annual cost-of-living adjustments are also awarded.

Medical

Benefits are awarded for adequate and reasonable medical care if a work-related illness or injury requires medical treatment. These benefits continue for as long as this treatment is needed. Workers are also entitled to reimbursement for prescriptions and travel costs for visits to treatment providers.

Employers can choose the doctor from their preferred provider arrangement for the first visit to a doctor or hospital. For more treatment, workers may select their own providers. Insurers can also periodically send workers for a medical evaluation by their own doctors.

Loss of function and disfigurement

Scarring or disfigurement is a work-related injury. Workers qualify for these benefits when a work-related injury or illness caused a permanent loss of certain functions, scarring or disfigurement. Scars must be on a worker’s face, neck, or hands.

A one-time payment is awarded for body function loss, disfigurement, or scarring. Its amount depends on the disfigurement’s location and severity or the lost function.

This benefit is paid with other benefits such as medical bills and lost wages. Different benefits are awarded if the injury or illness occurred before Dec. 24, 1991.

Survivors and dependents

Workers’ compensation also provides for a deceased worker’s family. A spouse or a child of a worker who died from a work-related injury or illness qualifies for survivors and dependent benefits. Children must be under 18, a full-time student or unable to work because of a physical or mental disability.

Surviving spouses may receive weekly benefits that are equal to two-thirds of the deceased worker’s average weekly wage up to the maximum of Massachusetts’ SAWW in effect when the work suffered their injury or illness. Spouses are also eligible for an annual COLA two years after the injury or illness date.

If the worker’s spouse remarries, each of their eligible children receives $60 per week. Dependent children may not receive weekly benefits exceeding the amounts the spouse was receiving.

Spouses may receive these benefits if they stay dependent and do not remarry. The insurer will also pay up to $4,000 for reasonable burial costs if a work-related injury or illness caused the worker’s death.

Injured workers may seek legal assistance to help determine which benefits they should seek and comply with Massachusetts’ procedures. Attorneys can also help assure that workers do not lose important rights.