Workers' Compensation Procedures

Objective

The Workers’ Compensation Service is located within Boston City Hall, Room 613. Workers’ Compensation Service administers benefits for City of Boston employees. The Workers’ Compensation Service strives to ensure effective and efficient delivery of benefits.

Administering of Workers' Compensation Benefits

In order for the City of Boston Workers’ Compensation Service to provide adequate service it is imperative that all work related injuries be reported as soon as possible, preferably the same day the injury occurred or within twenty-four hours of the occurrence or the day the Staff becomes aware of the injury.

Prompt notification of an employee’s injury will enable Workers’ Compensation Service to investigate the case thoroughly and expedite benefits to the employee once a decision is made to pay the claim. A decision on a case must be made within 14 days from Workers’ Compensation Service receiving notice of injury. Therefore, in order for this Department to provide benefits, your cooperation in obtaining medical documentation is critical. If a case is reported late, the employee’s receipt of benefits may be delayed.

Steps to take if you're injured on the job

1. Accident report should be completed within 24hrs of an injury and forwarded to the Workers’ Compensation office. If the injured employee is unable to complete the accident report please ensure that someone completes the accident report on their behalf. Reports can be sent via fax (635-3119), e-mail, mail, or hand delivered. (Please see accident report). If information requested is unknown, leave the line blank. This should not prevent an accident report from being forwarded. A supervisor’s signature is requested solely for the purpose of notification that an injury is being alleged. A supervisor’s signature does not indicate that the supervisor agrees/disagrees with the report, nor does it indicate the supervisor witnessed the accident.

EMERGENCY

IF EMERGENCY SERVICES (I.E. LIFE THREATENING, BLEEDING, HEAD INJURIES, SEVERE FRACTURES) ARE NECESSARY:

2. Seek out emergency care (via ambulance if necessary) at the closest emergency care facility to where you were injured, (only an emergency as indicated above).

3. After emergency care, your FIRST SCHEDULED APPOINTMENT MUST be with one of the City’s preferred provider medical vendors listed on the last page (Medical Documentation will be sent to Workers’ Compensation). Failure to do so may result in the employee being charged for service not compliant with the Preferred Provider Arrangement.

NOT AN EMERGENCY

4. If this is NOT an emergency, your FIRST SCHEDULED APPOINTMENT MUST be with one of the City’s [PPA] preferred provider medical vendors (listed on last page). Medical documentation will be sent to the Office of Workers’ Compensation Services [Room 613]. Failure to do so may result in the employee being charged for the service.

5. Medical expenses associated with work-related injuries will also be covered provided these expenses are reasonable, necessary and causally related to the incident alleged. However, salary replacement benefits for work related injuries are given only if the employee lost five days or more. Substantial medical documentation is required for employees who have lost five days or more.

6. Representatives from the Workers’ Compensation Service will be contacting you to follow-up on your injury, explain benefits, and ensure that you are receiving appropriate medical treatment. If you have not heard from a representative from this office call (617) 635-3193 to speak with a Case Manager. It may be that your accident report was not received.

7. If you are eligible for salary replacement benefits, please note that Workers' Compensation Service does not process any deductions from your workers' compensation check. For instructions of your deductions, please see your Personnel Officer in your Department.

Employee returning to work

An employee who has been out of work due to work related injury and has been receiving Workers’ Compensation benefits and is ready to return to work, must have medical clearance from his/her doctor releasing the individual. The Workers’ Compensation Office must be notified of any employee who returns to work while receiving benefits.

If you have not been notified if you are to receive Workers’ Compensation Benefits, you should notify the Workers’ Compensation Office when you have returned to the job. This will expedite the decision regarding your benefits.

Transitional modified work will be offered by the City to employees who have been injured on the job and are capable of returning to work on a modified basis. You will be notified by your Case Manager and/or your Department should you be eligible for modified work. The duration of the modified duty should not exceed three months.

The goals of the Workers’ Compensation office are to ensure that eligible injured employees receive quality and timely medical services, receive timely benefits, and return to the job as quickly as possible.

Your Case Manager will remain in constant contact with you, and you will be required to maintain contact and provide the necessary medical information to your Case Manager so that these goals can be achieved.

Any additional information or questions can be forwarded to the employee’s Case Manager. Case Managers are assigned based on the employee’s last name.

All accident reports regarding an employee’s injury should be faxed or forwarded to:

Workers’ Compensation Service
Boston City Hall, Room 613
Boston, MA 02201
Telephone: (617) 635-3193
Fax Number: (617) 635-3119