The workers' compensation policy is covered in the national workers' compensation guide: statutory benefits, employers liability, and premium based on payroll and classes. Massachusetts workers' comp law is M.G.L. chapter 152. It is administered by the Department of Industrial Accidents (DIA). Coverage comes from private insurers, self-insurance groups or licensed self-insurers. Massachusetts has no monopolistic state fund.

Who must provide coverage (c.152 s.25A)

Most employers must provide coverage, in one of three ways:

• insurance with an authorized insurer
• membership in a workers' compensation self-insurance group
• an annual self-insurer license

Workers' comp can't be placed with an unauthorized surplus lines insurer (c.175 s.168).

Who isn't an employee or can opt out (s.1(4)):

• A corporate officer or director owning at least 25% of the stock may opt out by filing a written waiver.
• A real estate salesperson paid only by commission isn't an employee.

Enforcement against uninsured employers (s.25C):

• An employer without required coverage gets a stop work order that halts business at the site.
• To lift it before a hearing, the employer shows coverage and pays $100 per day of noncompliance. The penalty is $250 per day after an unsuccessful hearing.
• The employer may appeal within 10 days. The order isn't in effect while a timely appeal is pending.

Exclusive remedy (s.24)

An employee who didn't reserve common-law rights in writing at hire is held to have waived the right to sue. The employee receives statutory benefits regardless of fault.

What is a compensable injury (s.1(7A), s.26)

• Frostbite, heat exhaustion or sunstroke suffered in the course of employment is conclusively presumed to arise from the job.
• Infectious diseases count when the hazard is inherent in the work.
• Mental or emotional disability arising principally from a bona fide personnel action, such as a demotion, is not compensable unless the action was an intentional infliction of emotional harm.
• Injuries from purely voluntary recreational activities, such as a company softball game or picnic, aren't compensable even if the employer paid.

Benefits

Waiting period (s.29):

• No weekly benefits unless the employee is incapacitated five or more calendar days.
• If incapacity lasts 21 days or more, benefits run from the first day. If it lasts 5 to 20 days, benefits start on the sixth day.

Serious and willful misconduct (s.28). If the employer's serious and willful misconduct caused the injury, compensation doubles, and an insured employer repays the insurer the extra. Knowingly employing a minor in violation of child labor laws counts as serious and willful misconduct.

Reporting and claims

• The employer reports an injury causing five or more days of incapacity to the DIA, the employee and the insurer within seven calendar days, not counting Sundays and holidays (s.6).
• The insurer starts payments, or gives notice that it refuses, within 14 days of the first report. If it doesn't, it owes a $200 penalty to the employee (s.7).
• A claim is filed within four years of when the employee first knew the disability was work-related (s.41).

Common exam traps

• Claims are handled by the Department of Industrial Accidents.
• TTD is 60% for up to 156 weeks. Partial benefits are capped at 75% of the TTD rate for 260 weeks.
• The waiting period is 5 days. Benefits are paid from the first day if incapacity lasts 21 days.
• Employer misconduct doubles compensation.
• An employee must reserve common-law rights in writing at hire to keep the right to sue.
• A stop work order carries $100 a day, and an employer can appeal within 10 days.