Jump ahead to learn:
- Is Workers’ Compensation insurance required in Massachusetts?
- How does Workers’ Comp work in MA?
- Workers’ Compensation benefits in Massachusetts
- MA Workers’ Compensation death benefits
- Massachusetts Workers’ Compensation insurance rates
- What if you don’t have Workers’ Compensation in Massachusetts?
- Who is exempt from MA Workers’ Compensation insurance rules?
- How NEXT helps Massachusetts business owners
Is Workers’ Compensation insurance required in Massachusetts?
Yes, all employers operating in the Commonwealth of Massachusetts must have workers’ compensation insurance for their employees and themselves if they are an employee of their own company. In Massachusetts, an employee is defined as “every person in the service of another under any contract of hire, express or implied, oral or written.”
The only exception is for domestic workers who must work at least 16 hours a week to be covered under a workers’ compensation policy.
Even family members must be covered by workers’ comp even if they are the only employees of the business.
Some employers may qualify for a self-insurance license. To qualify, employers must have at least 300 employees and $750,000 in annual standard premium.
How does Workers’ Comp work in MA?
In Massachusetts, the workers’ compensation system helps pay for any reasonable and necessary medical treatment related to workplace injuries or illnesses. It also pays compensation for lost wages after five calendar days of full or partial disability.
Typically, workers’ compensation in MA helps cover:
- Medical expenses
- Lost wages
- Rehabilitation and physical therapy services
- Retraining if you can no longer do your job
- Permanent injury
- Death benefits and survivor benefits
If an employee experiences a work-related accident or illness that results in at least five days of lost work time, you must report it to the state within seven days of the lost time. The Massachusetts Department of Industrial Accidents (DIA) administers the state’s workers’ compensation laws.
The first 180 days are considered a “Pay-Without-Prejudice” period, where the insurer may pay benefits without making a final decision.
Workers’ Compensation benefits in Massachusetts
Ill or injured workers can be eligible for the following workers’ comp benefits:
- Temporary total incapacity benefits. 60% of the employee’s gross average weekly wage of the 52 weeks before injury. This benefit lasts for 156 weeks.
- Temporary partial incapacity benefits. Up to 75% of the employee’s weekly total temporary benefits. The benefit lasts for up to 260 weeks.
- Permanent and total incapacity benefits. 66% of the employee’s gross average weekly wage. There is also an annual cost-of-living adjustment (COLA). This benefit lasts for as long as the employee is disabled.
- Medical benefits. Benefits include medical care, prescription reimbursement, mileage reimbursement and more. This benefit typically lasts for as long as medical services are required.
- Scarring and permanent loss of function and disfigurement. A one-time payment for the employee’s disfigurement or scarring, plus associated payments like medical bills or lost wages.
Sometimes, all parties may agree to a one-time, lump-sum payment instead of weekly compensation checks. Typically, when accepting the lump sum, the employee must give up certain rights.
MA Workers’ Compensation death benefits
If an employee has died as a result of a work-related injury or illness, their spouse, children and other dependents are eligible for survivor benefits. Children are eligible only if they are under age 18, are full-time students, or are unable to work because of physical or mental disabilities.
Surviving spouses can receive weekly benefits equal to 66% of the deceased worker’s average weekly wage up to the state’s maximum. They also become eligible for yearly cost-of-living adjustments two years after the injury or illness.
Workers’ comp coverage can also help pay for funeral expenses. Policies can pay burial costs up to eight times the state’s average weekly wage at death.
