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Many times, accident victims and injured workers end up speaking with the insurance adjusters after an accident before they consult with an experienced injury attorney. The insurance adjusters may be genuinely concerned and appear to want to help. However, sometimes, they are not completely upfront with injured workers.
Below is an example of why injured workers in Massachusetts shouldn’t automatically believe or trust what the insurance adjuster is telling them. While this is not always the case, it is highly recommended for an injured worker to speak with an experienced Massachusetts workers’ compensation attorney to make sure they are receiving the benefits they deserve.
About the Work Accident and Injuries in this Example
I recently met with a young man who was injured at work in Massachusetts. He is a laborer and hurt his fingers while using a power tool on the job. The way he described it, he dislocated his fingers, but was able to “pop” them back into place. He was in a lot of pain and tried his best to finish the day at work. He was mindful enough to follow our Three Important Steps to Take After Being Injured on the Job in Massachusetts and reported his accident and injuries right away to his supervisor.
Unfortunately, his fingers became very painful and swollen that night and he went to urgent care. At urgent care, x-rays were taken, which revealed that one of his fingers was fractured and required an evaluation by an orthopedic surgeon. The urgent care doctor gave him a disability note recommending that he stay out of work and a referral to an orthopedic.
After a delay in being able to see the orthopedic, this injured worker finally got an appointment. The orthopedic surgeon had new x-rays taken of this man’s fingers and, upon review, recommended open reduction internal fixation (ORIF) – a surgical procedure. The orthopedic surgeon gave the worker a disability note (to stay out of work) and then submitted a request for authorization to perform the surgeon. For reasons beyond the injured employee’s control, the surgery wasn’t scheduled for over 3 months. The injured worker finally had the surgery and is now in physical therapy working hard to get back to work.
The Injured Worker’s Concern with his Workers’ Compensation Claim
After months of being out of work with no pay and not receiving any benefits to cover some of the wages he was losing, this injured worker finally contacted a lawyer. When I met with this gentleman, he explained the history of his situation. This worker had not received any disability benefits from workers’ compensation, despite being out of work for over three months after his injury, until he had his surgery.
He says that shortly after his injury the insurance adjuster from his employer’s worker’s compensation carrier contacted him about his injury. The accident, injury, and doctor’s recommendations (e.g., to stay out of work and see an orthopedic surgeon) was explained to the insurance adjuster. For some reason, the insurance adjuster explained to this worker that he could not receive any disability benefits until he had his surgery, regardless of whether he returned to work or not. The worker, unknowingly, accepted this information as true and waited for his surgery to be scheduled. Once the worker had his surgery, the insurance adjuster began to pay temporary total disability benefits.
The major issue here is that for over three months this injured worker was unable to earn or receive any wages, pay, or benefits. This caused him significant financial hardship, which was very concerning, especially with a young family at home.
The Truth and What Can be Done to Help
The insurance adjuster is not being entirely honest in this situation and the injured worker shouldn’t have taken his word for it. Sure, the insurance company could (and many times do) raise a legitimate dispute regarding whether this injured worker was “totally disabled” while awaiting his surgery on his finger. However, to tell an injured worker that he is not entitled or eligible to receive workers’ compensation benefits until after he has his surgery is not entirely truthful. The best thing this worker did was to consult with a lawyer.
So, what can be done to help this worker? A Claim for Benefits can be filed with the Massachusetts Department of Industrial Accidents seeking the retroactive disability benefits for the closed period of time from when the worker went out of work until his surgery. The claim will then proceed through the normal course of a Massachusetts workers’ compensation claim.
Contact Our Massachusetts Workers' Compensation Attorneys Today
This is a great example of why an injured worker should always speak with an experienced Massachusetts workers’ compensation attorney after being injured on the job. The insurance adjusters will undoubtedly be contacting you after an accident. Many times, it may be fine. However, workers shouldn’t automatically believe what the insurance adjusters tell them and should confirm things with an attorney. Many attorneys, including us, offer free consultations where we will review your case, answer your questions, and explain what benefits are available. If you are concerned about what the insurance company is telling you after an accident, feel free to call us at (508) 879-3500.
