Who is Covered by Workers' Compensation?

The workers’ compensation system in Massachusetts is designed to make sure workers who contract a job-related illness or are hurt at work are not unfairly left to cope with the physical and financial fall-out on their own.

Under MGL ch. 152, the Massachusetts Workers’ Compensation Act, employers in the Commonwealth have certain obligations. Per §25A of that law, virtually all employers in Massachusetts are required by state law to keep workers’ compensation insurance to cover their employees – including themselves – in case of a work-related injury or illness.

At Jeffrey Glassman Injury Lawyers, our Boston workers’ compensation attorneys know this requirement is applicable to all workers, no matter how many hours they work (except for domestic service workers, who have to maintain a minimum of at least 16 hours weekly).

The law serves to supply injured or disabled workers with partial wage replacement and medical care. On the reverse side, it shields employers from negligence lawsuits from employees, which could be extremely damaging to their bottom line.

In a negligence lawsuit, filed within the civil court system, it is necessary for plaintiffs (those making the claim) to assert legally-recognized theories of wrongdoing by the defendant, and to support those claims with facts.

The rules are different in workers’ compensation law. It is not necessary to prove the company did anything wrong to cause the accident or exposure resulting in injury or illness. It’s also not necessary (in most cases) to show the worker was blameless. What matters is that that the harm arose out of one’s employment and occurred within the course and scope of one’s employment.

In other words, the question of causation and whether the injury was work-related is more important than who is at fault.

In order to be compensable through workers’ compensation, an injury or illness must arise out of and in the course of employment.

The interpretations for this standard vary depending on jurisdiction.

In Massachusetts, the definition for this standard is detailed in MGL ch. 152 § 26.

In order to show an injury “arose out of” one’s employment, there needs to be evidence that there was a causal connection between the work and the injury. Typically, it’s the worker who bears the burden of showing the injury was caused by exposure to an increased risk from employment.

Injuries are typically as one of the following:

• Risk that is distinctly associated with employment. These would be things like a painter falling from a scaffold on a job site, an electrician suffering an electrocution while wiring a new structure, etc. These are always compensable.
• Risk that is personal to the claimant. These would be things like a person who smokes developing lung cancer following years of smoking. These are generally never compensable unless the pre-existing condition was exacerbated by a work-related condition or injury.
• Neutral risk. These are neither distinct from employment or the person. They are the most problematic in terms of whether coverage is warranted. For example, a restaurant worker is bitten by a stray dog while emptying trash into an outside receptacle. Another example would be a social worker shot in a drive-by shooting after leaving a home visit. In these cases, coverage is less clear.

In some situations, idiopathic injuries – or those that result from personal risks to the employee, as opposed to those associated with work, could be compensable if the job contributes to it or aggravates it. For example, a worker who skipped breakfast might get dizzy and faint. That won’t be compensable. However, if in so doing, she falls and hits her head on a desk and cracks her skull, that could be compensable.

In order to show an injury occurred” in the course of employment,” it has to have taken place in a location where it’s reasonable to be, in a place within the employment period and while the worker is fulfilling employment duties. This doesn’t necessarily mean the worker has to actually be doing his or her job, or be within working hours.

Distinguishing which incidents trigger the “in the course of employment” requirement is tricky.

For example, the “coming-and-going” rule bars workers’ compensation coverage of injuries that occur while a worker is traveling to and from work. However, workers may be covered if they were leaving work, but still on work property.

Sorting out the intricacies of workers’ compensation law can be a difficult task. We can help.

Contact Jeffrey Glassman Injury Lawyers today for a free and confidential consultation.