Injured Workers in Massachusetts – Are You Aware of the 28-Day Rule?

In typical Massachusetts workers’ compensation claims, an injured worker suffers injuries on the job that prevents them from returning to work and earning their pay. In many situations, the injured worker receives weekly disability checks to replace a portion of their wages and medical benefits to cover the costs of treatment.

Some injured workers may make progress with medical treatment to get back to work. If the injured worker returns to work, their weekly workers’ compensation disability benefit checks will stop. But what happens after the worker returns to work and is then forced to go back out of work because of the same injury? There are certain protections afforded injured workers in the Massachusetts Workers’ Compensation Act. This is where the 28-Day Rule comes in.

Basics of Massachusetts Workers’ Compensation Benefits

When a worker is injured on the job in Massachusetts, he or she is eligible for workers’ compensation benefits. The benefits available depend on the extent of the injury and disability.

If the injured worker is completely unable to return to work because of their injury, they are eligible for temporary total disability benefits. Similarly, if a worker is injured on the job and is only able to work light duty or work with restrictions, they are eligible for temporary partial disability benefits if they are unable to earn their pre-injury average weekly wage.

Additionally, when a worker in Massachusetts is hurt on the job and requires medical treatment, the Massachusetts Workers’ Compensation Act requires the workers’ compensation insurer to cover the costs and expenses of medical treatment.

Summary of the 28-Day Rule in Massachusetts Workers’ Compensation Claims

As stated above, in some cases, an injured worker makes progress with medical treatment and will return to work. It’s almost considered a trial run to see if the worker can physically perform their duties and responsibilities at work and earn their wages. The Massachusetts Workers’ Compensation Act provides a 28-day time period for this attempt. Let’s see how it works.

When an employee returns to work after their work injury, if, within twenty-eight (28) days from their return to work, the injured worker must leave work because of the same work injury that initially kept them out, the insurer shall resume disability payments. This rule or requirement falls under M.G.L. c. 152 § 8(2)(c). However, injured workers in Massachusetts must be mindful of certain requirements for this rule to apply.

If a worker returns to work and then, within 28-days, leaves work again because of the initial work injury, they must notify their employer and workers’ compensation insurer within 21 days of leaving work that their work injury renders them unable of continuing their work (i.e., that they are disabled from work). The Workers’ Compensation Act in Massachusetts requires this notification to be sent by certified mail.

Also, keep in mind that this 28-day rule that requires insurers to resume payment of disability benefits applies in workers’ compensation claims where the insurer has accepted liability or liability has been established by a finding of an administrative judge at the Massachusetts Department of Industrial Accidents.

If all these requirements are satisfied, under the laws in Massachusetts, the workers’ compensation insurance company must resume payments of disability benefits.

An Example of How the 28-Day Rule Works

Our Framingham workers’ compensation lawyer, Chuck Pappas, represented an injured worker who was hurt on the job in Worcester, Massachusetts. This worker injured his lumbar spine on the job. His work accident resulted in a mild to moderate herniation in one of the discs in his lumbar spine. He suffered significant pain in his lower back that radiated into his legs. This injury prevented him from returning to work for a while.

This worker’s employer had workers’ compensation insurance. The work accident was reported timely, and the insurer voluntarily paid our client weekly disability benefits. The insurer also paid for all of the medical treatment, including visits and examinations with an orthopedic spine specialist, physical therapy, an MRI, and lumbar spine steroid injections.

This worker was out of work for approximately eight months undergoing treatment of his low back injury. Since the insurer paid this worker disability benefits beyond the 180-day payment without prejudice period (and the employee did not agree to an extension of the payment without prejudice period), liability was accepted by operation of law in this workers’ compensation claim.

After roughly eight months of treatment, this worker felt better, and tried to go back to work. When he went back to work, his weekly disability checks stopped. However, within the first two weeks (less than the 28-day rule), he was unable to continue working because of his low back pain and injury. Thus, he left work, saw his orthopedic spine specialist, and the doctor advised him to stay out of work.

Our office sent a certified letter to this employee’s employer and the workers’ compensation insurer notifying them of our client’s disability resulting from the injury that rendered him incapable of performing his work duties. This was done within 21-days from when our client left work. The workers’ compensation insurer then resumed payments of weekly disability benefits as required under the 28-Day Rule.

As you can see, there are many requirements and conditions under the laws in Massachusetts, especially in workers’ compensation cases. This is why it is always highly recommended that injured workers consult with an experienced Massachusetts workers’ compensation attorney. Most lawyers will offer free consultations, as we do, to answer any questions, provide injured workers with their legal options, and be ready to take legal action, if necessary.