Employers paying a medical-only claim instead of reporting it
Some states have approved what is called "Ex-Medical" coverage, which allows payment of medical-only claims by employers. This isn't allowed in Massachusetts largely because all the relevant statutes, including MGL c. 152, § 30 states: "The insurer shall furnish to an injured employee adequate and reasonable health care services . . . "
Some employers would like the ability to pay small medical claims themselves in order to keep those losses out of their experience rating calculations, but it turns out that such experience is actually relevant to the likelihood of having future claims. So, keeping the information out of the calculation would make the rating system less accurate.
Every employer MAY require its insurer to put them on a small deductible plan; taking that option would require them to pay per claim deductibles up to the prescribed limit and get the up-front premium reductions. But, claims are still counted for purposes of experience modification because use of that information has been determined to be actuarially sound.
Paying an injured worker for the entire day of the injury
The only requirement under state law is employers need to pay workers for the hours actually worked. However, if the employer does pay the worker for just the hours worked, then the day the worker was injured would be considered the 1st calendar day of disability. If the employer pays the worker the entire day, or shift, then the next calendar day would be considered the 1st day of disability.
Filing a Form 101/Employer's First Report when an employee gets hurt and then quits
If the injury would have resulted in 5 or more full or partial calendar days of disability, you would need to report this accident. The 1st missed day would be the 1st day the employee couldn't earn full wages due to the injury, and the 5th lost day is the 5th calendar day of disability.
Starting a business and getting workers' compensation insurance
You can get insurance through any insurance agent or broker who handles business insurance or through a direct writer of insurance.
For more information, including what you should be paying for insurance call the Workers' Compensation Rating and Inspection Bureau of Massachusetts at (617) 439-9030.
If you feel your rates are too high, you can appeal to the Board of Appeals within the Massachusetts Division of Insurance, (617) 521-7777.
Questions about your experience modification
Call the Insurance Rating Bureau, (617) 439-9030.
Questions on the assessment of your workers' compensation insurance
Call the DIA Assessments Office at (617) 626-5484
Replacing an employee who is injured and collecting workers' compensation
Unless a union contract, or the individual's contract of hire, requires it, an employer doesn't have to hold an injured worker's job open while they are unable to work due to an occupational accident.
However, MGL c. 152 § 75A does require employers to give preferential treatment in the rehiring of injured workers when they are ready to return to work. MGL c. 152 § 75B requires that employers make all reasonable accommodations to anyone who is deemed to be a qualified handicapped person under MGL c. 151B.
You may also have obligations under the Americans with Disabilities Act (ADA).
Your rights as an employer during the claim process
It's your right as the employer to attend the Conciliation, Conference and/or Hearing proceedings; however, you can't participate unless you're called as a witness. For this reason, all employers are encouraged to maintain well documented records of all accidents and reports including names of witnesses.
If you have any pertinent information relating to any claims, you should inform your workers' compensation insurer, or your insurance agent.
While the insurer is the legally interested party during the claims process, the employer will receive notice of Conciliation, Hearing, Lump Sum Conference or any proceeding involving employer misconduct (MGL c. 152, § 28). You are required to attend only the § 28 Willful Misconduct proceedings.
Reporting an employer or injured worker who may be defrauding an insurance company
To report an employer who doesn't have worker's compensation insurance, call our hotline,1-877-MASSAFE ((877) 627-7233) Ext. 7313;
To report injured worker fraud, you should contact the insurer directly, and notify the Insurance Fraud Bureau, at 1-800-32-FRAUD, or (617) 439-0439.
Questions about qualified loss management
Contact the MA Workers' Compensation Insurance Rating Bureau, (617) 439-9030.
OSHA Log 300
Call OSHA in Boston at (617) 565-9860 or visit their website: OSHA Forms