Workers’ Compensation FAQs - Part 2

If I Am Approved For Permanent And Total Disability, Does It Mean Benefits Last Forever?

The simple answer to that question is no. As a practical matter, many people who are approved continue to collect benefits indefinitely without interruption. However, once approved for permanent and total disability, the insurer is allowed to have the employee re-examined and can bring the employee before the Department of Industrial Accidents in an attempt to show the employee's medical condition has improved.

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What Is The Basic Test To Determine Whether An Injury Is Compensable?

Our workers' compensation law covers both accidental injuries that happen at one particular place and time and occupational diseases, which may result in disability after many years of exposure, provided they "arise out of and in the course of the employment". The work exposure does not have to be the sole cause of the injury or condition to be compensable. Work activities which aggravate or accelerate or hasten an underlying condition, usually satisfy the burden of proof necessary to receive benefits. The fact that injury might have been caused by the workers' own negligence or negligence of a fellow employee is immaterial to the compensability of the condition.

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Does The Injury Have To Happen At One Particular Point Or A Specific Place And Time?

Injuries that occur at a given and specific place in time are usually easier to prove, however, repetitive stress injuries such as hand and wrist problems, carpal tunnel syndrome for example, caused by constantly doing certain job functions are indeed compensable. These conditions are sometimes called "repetitive stress injuries" or "overuse syndrome".

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What If I Have A Pre-Existing Medical Condition That Is Aggravated By Work Activities?

Massachusetts workers’ compensation laws can make it more difficult to collect for pre-existing conditions. It must be shown that the work contribution to the medical problem is a major cause of the current disability (but not necessarily the predominant cause). Cases in this area are technical and somewhat complicated, and competent legal advice is very important to establish causality.

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Are Nervous Breakdowns And Emotional Problems Covered?

Yes, in some circumstances. However, the standard for compensability for these types of injuries places a greater burden on the employee in terms of proof. To be compensable, the employee must show that a specific event or series of events on the job is the predominant cause of the resulting disability. Also, mental or emotional disabilities which are the employee's reaction to a "bonafide personnel action" are excluded.

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What About Heart Attacks And Strokes?

These types of injuries have for many years been held to be compensable. However, as with many types of injuries, it is always easier to collect if an immediate report of the work-related event is made and it can be tied into a specific event that occurs at a given date and time. Again, competent legal advice and strong medical support is essential for these types of claims.

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Does Massachusetts Cover Occupational Diseases?

Occupational diseases are fully covered under the Massachusetts Workers' Compensation Law. Conditions such as asbestosis, asthma, dermatitis, or chemical reactions have been commonly held to be compensable. Many insurers do not routinely accept these conditions, and claims have to be filed to secure benefits. It should be noted that Massachusetts has a time limit for filing claims for work-related injuries or diseases. The general rule is that the employee must file a claim within four years of the date of injury. In cases of occupational disease, the time begins to run when an employee first becomes aware of the causal relationship between his condition and his job activities.

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Injuries For Traveling Employees

Basically, employees that are required to travel away from their home, or usual place of business, especially those away on an overnight basis, have essentially twenty-four hour around the clock coverage since they are considered to be on sort of a special errand during the entire day. Even if they were out socializing after a work day, an injury sustained under those circumstances may be compensable on a business trip, even though such an injury otherwise might not be compensable.

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