Issues Concerning Disability Benefits from Workers Compensation for the First 5 Days of Disability

This is an issue raised quite often after a work-related accident in Massachusetts. It usually comes up shortly after the accident when an injured worker receives his or her first disability check from the workers’ compensation insurance company. Injured workers usually notice that the first disability check is low, because it doesn't’t include the first five (5) days following the injury.

The answer to this question requires a general understanding of the laws that govern workers’ compensation in Massachusetts. Below I will provide a brief overview of what is required for an injured worker to be entitled to disability benefits, including the first five days of his or her disability.

Overview of Massachusetts Workers’ Compensation

The Massachusetts Workers’ Compensation Act is in place to make sure that workers are protected and covered by insurance in the event they are injured in an accident while they are in the course of their employment or contract a work-related illness. The vast majority of employers in Massachusetts are required to purchase and carry workers’ compensation insurance for all their employees. This insurance policy provides benefits, including disability benefits and medical benefits to employees injured on the job.

Disability benefits are weekly compensation checks paid to an injured worker who suffered an injury on the job and is unable to work due to the injury. The amount of disability benefits depends on whether the worker is totally or partially disabled and the amount of his or her average weekly wage. Medical benefits pays for any necessary medical treatment that is related to the injury suffered on the job.

Generally, when a worker is injured on the job in Massachusetts and the injury prevents him or her from working, he or she is entitled to workers’ compensation disability benefits, among others.  An injured worker must miss five (5) full or partial calendar days of work  due to the injury before he or she qualifies for workers’ compensation disability benefits. These days are not required to be consecutive.

Disability Benefits for the First Five Days of Disability

The question of whether the worker is entitled to compensation for the first five (5) days of work missed due to the injury depends on how long the worker is disabled. If a worker is unable to work due to the work injury for more than twenty-one (21) days, the workers’ compensation insurer must pay the injured worker the disability benefits for the first five (5) full or partial days of disability.  

If, however, the worker misses more than five (5) days due to the work injury, but less than twenty-one (21) days, then the workers’ compensation insurer is required to only pay disability benefits from the sixth (6th) day of work missed through the day he or she returns to work.

Let’s look at an Example: A man from Framingham, MA falls at work and suffers a serious back injury. The injury is reported properly, and his employer’s workers’ compensation insurance company reviews the accident. Within two weeks of the accident, they decide to voluntarily pay him temporary total disability benefits. The first check arrives in the mail a little more than two weeks after the accident. The worker reviews the check and check stub and notices that the first disability payment didn't include the first five days after he was injured in the accident. He’s confused and wonders why he didn't receive benefits for the first five days. This is because he has not yet missed more than 21 days. Remember, if he misses more than 5 days, but less than 21 days, he is only entitled to disability benefits from the 6th day until he returned to work. But, if he missed more than 21 days of work because of his injury, then he would be entitled to receive disability benefits for the first 5 days of his disability. So, if this worker remains out of work because of his injury for more than 21 days, he will be entitled to receive compensation for the first 5 days he was out.

What to do if You Are Not Receiving the Benefits You Deserve?

After being injured on the job, if your employer’s workers’ compensation insurer denied your claim or refuses to pay you benefits, including disability benefits for the first five (5) days you missed after your accident, you have the right to take legal action and file an Employee's Claim for benefits.  For information on the process of a Massachusetts workers’ compensation case or answers to other questions, you should consult with an experienced Massachusetts workers’ compensation attorney. 

Attorney Chuck Pappas of Mahaney & Pappas, LLP in Framingham, Massachusetts specializes in helping injured workers get the benefits they deserve. Our office handles workers’ compensation claims throughout Massachusetts and are willing to review your case for free, answer your questions and explain how we may be able to help you get the compensation you deserve.

Do You Have a Question About a Work Accident in Massachusetts?

If you have been injured in a work related accident in Massachusetts and have questions about your rights, feel free to call us at (508) 879-3500 or contact us online to set up a time to speak with Attorney Chuck Pappas. This meeting is complementary and might be the best decision you make.

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