You were hurt on the job. You did everything right. You reported the injury, saw the doctor, and stayed out of work to heal. Then the insurance company either refused to pay your weekly benefits or, after a few months of checks, cut them off. Now the bills are piling up, and you are asking the same question so many injured workers ask: if I win my case, will I get back the money I lost?
The short answer is yes. The longer answer explains why time matters so much, and why speaking with an experienced Massachusetts workers' compensation attorney as early as possible can make a real difference for you and your family.
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Quick Answer Yes. In Massachusetts, an injured worker can recover retroactive workers' compensation benefits, often called back pay. If an insurer denies your claim or stops paying weekly disability benefits, your attorney can file a claim with the Department of Industrial Accidents (DIA) asking a judge to order payment from the date of your injury or from the date your benefits were terminated. If you win, the insurer must pay the benefits you went without. The catch is that the process takes time, and you may have no income while you wait. That is why being prepared and filing quickly matters. |
What Are Retroactive Workers' Compensation Benefits?
Retroactive benefits are weekly disability payments that cover a period of time that has already passed. Instead of starting payments on the day a judge rules in your favor, the order can reach back to an earlier date, such as the date you were injured or the date the insurer stopped paying.
In Massachusetts, weekly benefits are usually paid under Section 34 (temporary total incapacity) or Section 35 (temporary partial incapacity) of the workers' compensation law, Chapter 152. When we file a claim on your behalf, we ask for those benefits from a specific start date. If the judge agrees, the insurer owes you every week of benefits from that date forward, including the weeks or months you went without a check.
When Do Injured Workers Need to Seek Retroactive Benefits?
Most retroactive benefit claims arise in one of three situations.
1. The Insurer Denied Your Claim From the Start
After your employer reports a work injury that keeps you out of work for five or more days, the insurer has a short window to decide whether to start paying or to deny the claim. If the insurer denies it, you receive nothing. In that case, the claim we file asks for weekly benefits from the date of your injury (or the date your disability began).
2. The Insurer Paid, Then Terminated Benefits During the Pay-Without-Prejudice Period
Many injured workers are surprised to learn that early payments do not mean the insurer has accepted their case. Massachusetts allows insurers to pay benefits for up to 180 days under what is called the pay-without-prejudice period. During this time, the insurer can stop or reduce your weekly checks by giving you seven days' written notice, without first asking a judge for permission. The DIA's form for this is called the Insurer's Notification of Termination or Modification of Weekly Compensation During Payment-Without-Prejudice Period.
When that happens, the claim we file asks for benefits from the date your benefits were terminated. If the judge orders the insurer to resume payment, the order covers the entire gap.
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Example: How Back Pay Works After a Termination An injured worker is hurt on the job, goes out of work, and begins receiving weekly disability benefits. A few months later, during the pay-without-prejudice period, the insurer sends a notice and stops paying. She hires an attorney, who files a claim seeking benefits from the date of termination. By the time her conference before a DIA judge arrives, she has gone four months without a check. If the judge orders the insurer to pay benefits from the termination date, she is owed all four months of back benefits, plus ongoing weekly payments. This example is for illustration only. Every case is different, and results depend on the facts and the evidence. |
3. Your Benefits Were Reduced (Modified)
Sometimes an insurer does not stop payments entirely but cuts them, for example by switching you from total to partial disability benefits. If the reduction is not supported by the medical evidence, we can file a claim seeking the difference, retroactive to the date of the reduction.
Once the pay-without-prejudice period ends without a termination, the rules change. In general, the insurer can no longer simply stop paying on its own. It must seek permission through the DIA. If an insurer stops or reduces benefits improperly, additional remedies, including penalties, may be available.
How Retroactive Benefits Are Sought Through a Massachusetts Workers' Comp Claim
Here is how a claim for back pay typically moves through the Massachusetts Department of Industrial Accidents. Our free Guide to Massachusetts Workers' Compensation Claims covers each step in more detail.
- The claim is filed. Your attorney files an Employee's Claim with the DIA, identifying the benefits sought and the date they should begin.
- Conciliation. The case is first scheduled for an informal meeting with a DIA conciliator to see whether the dispute can be resolved. If not, it moves forward.
- Conference. An administrative judge hears arguments and reviews medical records at a conference. The judge then issues a conference order, which can require the insurer to pay benefits, including retroactive benefits.
- Hearing. Either side can appeal a conference order to a full evidentiary hearing, with testimony, an impartial medical examination, and a written decision.
At each stage, we are asking for one thing: an order requiring the insurer to pay what you are owed, starting from the date of your injury or the date your benefits were cut off. When that order comes, the retroactive benefits come with it.
Time Is of the Essence: The Hardest Part Is the Wait
Retroactive benefits are real, and they are valuable. But they do not pay this month's rent.
From the day a claim is filed to the day a judge hears it at conference, weeks or often months can pass. During that time, an injured worker whose benefits were denied or terminated usually has no weekly income and no benefits to cover the monthly costs of life: the mortgage or rent, the car payment, utilities, groceries, insurance, and the needs of their family. Many injured workers drain their savings, borrow from relatives, or fall behind on bills while they wait.
This puts injured workers in a very difficult financial position, and the insurance company knows it. Financial pressure is one of the reasons some workers give up, go back to work before they are ready, or accept less than their claim is worth.
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Why Attorney Pappas Files Fast The clock on your case does not start until a claim is filed. Every week of delay is another week before you can get in front of a judge, and another week without income. That is why Attorney Pappas works quickly to get your claim filed, so your case enters the DIA process as soon as possible and you are on the path to an order for ongoing and retroactive benefits. |
Why You Should Talk to an Experienced Massachusetts Workers' Comp Attorney Right Away
It is highly recommended that injured workers consult an experienced Massachusetts workers' compensation attorney after a work injury if any of the following is true:
- You have not started receiving weekly benefits, or the insurer has denied your claim.
- Your benefits were reduced (modified), for example, from total to partial disability.
- Your benefits were terminated, during or after the pay-without-prejudice period.
- The insurer has asked you to sign an agreement (Form 105) extending the pay-without-prejudice period, or any other form you do not fully understand.
An experienced attorney makes sure legal action is taken promptly and correctly. That means filing the right claim, asking for the right start date, gathering medical evidence to support your disability, preparing you for conciliation and conference, and holding the insurer to the deadlines and rules Massachusetts law requires. When your payments are stopped or reduced, time is truly of the essence.
Attorney Charles S. Pappas has more than 20 years of experience fighting for injured workers across Massachusetts, including healthcare workers and nurses hurt on the job. When you hire Pappas Law, Chuck handles your case personally. You can read what one client said after her workers' comp benefits were terminated and Attorney Pappas fought back.
Free, No-Obligation Consultation: There Is No Risk
If you are worried about the cost of hiring a lawyer, you do not need to be. Attorney Pappas offers free consultations with no obligation. You can talk through what happened, learn your rights, and get a clear answer about your options without paying anything and without committing to hire the firm. There is simply no risk in making the call.
Attorney's fees in Massachusetts workers' compensation cases are regulated by state law, and Attorney Pappas will explain exactly how fees work in your situation during your consultation.
Frequently Asked Questions About Retroactive Workers' Comp Benefits
Will I get back pay if my workers' comp benefits were stopped in Massachusetts?
You can. If your attorney files a claim seeking benefits from the date of termination and the judge rules in your favor, the insurer must pay the benefits you missed, along with ongoing weekly payments.
From what date are retroactive benefits paid?
It depends on your situation. If your claim was denied from the start, the claim usually seeks benefits from the date of injury or the date disability began. If benefits were paid and then stopped, the claim usually seeks benefits from the termination date.
Can the insurance company stop my benefits without going to a judge?
During the pay-without-prejudice period, which is generally the first 180 days and can be extended up to one year with your written consent, the insurer can stop or reduce benefits with seven days' written notice. After that period, it generally needs DIA approval.
How long does it take to get to a workers' comp conference?
It varies with the DIA's schedule and the facts of the case, but it generally takes a few months after a claim is filed. Filing promptly is the best way to avoid unnecessary delays.
Should I sign an agreement extending the pay-without-prejudice period?
Talk to an attorney first. Extending the period keeps the insurer's right to stop paying with short notice for longer. Whether signing makes sense depends on your case.
Is a consultation with Attorney Pappas really free?
Yes. Consultations are free and come with no obligation.
You can find more answers on our FAQ page, in our videos, and in our free Guide to Massachusetts Workers' Compensation Claims. If you are weighing a settlement, read when to consider a lump sum settlement.
Your Benefits Were Denied or Cut Off. Call Pappas Law Today.
Don't wait while the bills pile up.
If your workers' comp claim was denied, or your weekly benefits were reduced or terminated, every week counts. Contact Pappas Law for a free, no-obligation consultation with Attorney Charles S. Pappas.
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We understand that being hurt on the job can be extremely stressful. After a serious injury, you may not only be losing time at work and your paycheck, but you may require extensive medical treatment which can be costly. You are probably concerned about how you are going to provide for yourself and your family and how you are going to cover the cost and expense of your treatment. These are completely valid concerns. Injured workers in these positions need the help of an experienced Massachusetts workers’ compensation attorney..png)
A work accident isn't something most think about often until it happens to them. This is why injured workers typically have many questions and concerns after being seriously injured on the job. If you were hurt at work, you should have a good understanding of the workers’ compensation process and benefits available in Massachusetts. The experienced workers’ compensation lawyer at Pappas Law, is here to help you during this difficult time.