Boston Massachusetts UR Agent Complaint for Workers' Compensation

State:
Massachusetts
City:
Boston
Control #:
MA-133A-WC
Format:
PDF
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Description

This is one of the official Workers' Compensation forms for the state of Massachusetts.

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FAQ

Under the workers compensation law, (MGL c. 152, § 41) for injuries on or after January 1, 1986, a claim must be filed with the insurer within 4 years of the date you become aware of a connection between your injury/illness and your employment.

Phone Call Public Information Office at (857) 321-7470. TTY Call Public Information Office, TTY at (800) 224-6196. Toll Free In Massachusetts Only Call Public Information Office, Toll Free In Massachusetts Only at (800) 323-3249.

Can You Lose Your Job While on Workers' Compensation in Massachusetts? Legally, you cannot lose your job. Again, your workers' compensation is your right as an employee in Massachusetts. And so, your employer or employers should not terminate your appointment because you were demanding your rights.

Your Total Disability Benefit rate is sixty (60%) of your average weekly wage. So, once you have determined your average weekly wage, you would multiply it by 60%. For Example: If a worker had an average weekly wage of $750.00, their Temporary Total Disability Benefits would be $450.00 per week ($750 X 60%).

Up to 260 weeks or 5 years. However, you are entitled to 7 years of benefits when combining Temporary Total and Temporary Partial Disability. For example, if you receive 3 years of temporary total disability benefits, you cannot receive an additional 5 years of partial disability benefits.

What is the statute of limitations? Under the workers compensation law, (MGL c. 152, § 41) for injuries on or after January 1, 1986, a claim must be filed with the insurer within 4 years of the date you become aware of a connection between your injury/illness and your employment.

The days don't need to be consecutive. You have 7 calendar days (except for Sundays and legal holidays) after the injured worker's 5th day of full or partial disability to report the injury to the DIA. You need to file the Form 101- Employer's First Report of Injury/Fatality electronically.

To request a review of a decision by the WCB's Review Division, get the Request for Review form online or by phone at 1-888-855-2477. Complete the Request for Review form and submit it to the Review Division within ninety (90) days of the date that the WCB decision or order was made. The address is on the form.

If the insurer has commenced benefits timely, namely within 14 days of notice, the insurer is allowed to stop payments to the employee without obtaining approval of the DIA or the consent of the employee. However the insurer is required to give the employee seven(7) day written notice of their intent to stop benefits.

C. 152, Workers' Compensation Act. This regulation is referred to as the ?fee schedule? and contains 12 separate sections that list rates used to pay for health care services delivered by ambulatory provider types, such as physicians and physical therapists.

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Boston Massachusetts UR Agent Complaint for Workers' Compensation