Only the insurer has the right to file for Cost-Of-Living-Adjustments (COLA) reimbursement with the Department of Industrial Accidents (DIA). The insurer's right to reimbursement is contingent on proof that COLA was paid, that it was due when paid, that the amount paid was figured correctly, and that the request for reimbursement was submitted timely under 452 CMR 3.03(3), i.e., within 2 years from the date the COLA payment was due.
Insurers must submit the following documents in addition to the form for COLA reimbursement.
- Indemnity records - proof of payment. Insurers must provide a record of what has been paid out to the claimant. These records may also be used to confirm that the reimbursement request was made in a timely manner.
- Proof that payments were due. Insurers must send out an annual CR 28 Form.
- This form will serve as proof that the insurer has not been paying COLA unnecessarily. Workers' Compensation insurance benefits are not affected by collecting Social Security benefits. However, if someone is receiving social security disability benefits, that could affect any cost of living adjustments. More information on this is available from the Social Security Administration. See also Guidelines for Insurers provided by SSA.
- Documentation supporting an obligation to pay either § 34A or 31 benefits. Insurers must provide a copy of the order or agreement that establishes their obligation to make payments under §31 or § 34A. Without proof of their obligation the insurer will be unable to prove COLA was in fact due, and therefore will not be reimbursed.
§ 34A claims
- In addition to the above documents any insurer requesting COLA reimbursement from the Trust Fund for a § 34A claim must also provide recent medicals to support the claim of permanent and total disability.
§ 31 claims
- In addition to the above documentation an affidavit from the widow stating that they are in fact still a dependent of the deceased may be required.
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