Delayed Benefits and Denial of Claims

Bristol County Attorney Aiding People in the Pursuit of Workers’ Compensation Benefits

The Massachusetts Workers’ Compensation Act (the Act) provides that employees who suffer work-related illnesses or injuries can recover workers’ compensation benefits. While some injured employees receive their benefits promptly, others must contend with delayed benefits and denial of claims. People hurt at work often need workers’ compensation benefits to make ends meet, and delayed payments can cause economic hardships. If you filed a workers’ compensation claim and it was denied, or you have not received benefits, you should speak to an attorney about your options. James K. Meehan of the Law Office of James K. Meehan is a trusted Bristol County workers’ compensation lawyer with the skills and experience needed to help you fight to protect your rights, and if you engage his services, he will diligently pursue the best possible outcome in your case. Mr. Meehan regularly represents people in workers’ compensation matters in Bristol County and in Plymouth and Norfolk Counties.

Reasons for Delayed Benefits and Denial of Claims

People who sustain illnesses or injuries because of their employment can often recover workers’ compensation benefits from their employer’s insurers. In order to recover benefits, a person must first provide his or her employer with written notice of the harm suffered. The employer must then file an electronic form reporting the injury with the Department of Industrial Accidents (DIA). The form must be shared with the employee and the employer’s workers’ compensation insurer as well. The insurer then has to investigate the claim and determine whether it should be paid or denied.

There are numerous factors that can cause delayed benefits or denial of claims. For example, benefits are only available for sick or injured employees, and cannot be recovered by volunteers or independent contractors. Thus, if an employer or insurer disputes a person’s employment status, it can lead to a delay or denial of benefits. Additionally, the harm suffered must be work-related, which means it must arise during the course and scope of employment. As such, if the parties disagree about the cause of the employee’s sickness or wound, it can result in denials and delays as well. Finally, a claim may be denied or deferred because the employee provided the employer with late notice of the injury.

Recourse for Delayed Benefits and Denial of Claims

If an insurer denies a claim or fails to issue a decision within fourteen days of receiving the claim, the employee can file a claim with the DIA. Once the DIA receives the employee’s claim, it will schedule a conciliation within two weeks. If the parties are unable to come to an agreement during conciliation, and the conciliator determines that there is adequate evidence in support of the employee’s claim, the matter will then be sent to the Division of Dispute Resolution, who will schedule a conference with an administrative judge. Following the conference, the judge will issue an order granting or denying benefits. Either party can then appeal the order, after which the DIA will schedule a hearing with a judge. The judge will review evidence from the parties and issue a decision based on that evidence. Generally, at this level, the parties must demonstrate that the judge made an error of law to file an appeal.

Speak to a Trusted Bristol County Attorney

Workers’ compensation benefits provide financial relief for many injured workers, but delayed benefits and denial of claims can cause frustration and economic hardships. If you suffered injuries while working, you may be owed workers’ compensation benefits, and it is smart to speak to an attorney to evaluate your rights. James K. Meehan of the Law Office of James K. Meehan is a trusted lawyer who is well-versed in what it takes to achieve winning results in workers’ compensation cases, and if you hire him, he will gather the evidence needed to help you seek a favorable outcome. Mr. Meehan’s office is in Taunton, and he regularly represents injured employees in workers’ compensation claims in Bristol County and also in Plymouth and Norfolk Counties. You can contact Mr. Meehan by calling 508-822-6600 or via the form online to set up a complimentary and confidential consultation.