The Injured Workers Survival Guide

This special online Injured Workers Survival Guide will help you navigate the murky water of the Massachusetts Worker's Compensation system.

You can CALL for a free copy of the Injured Workers Survival Guide 2004. This is a guide to the resources available in Western Massachusetts for people who are in financial difficulty. Topics covered include transportation, food pantries, fuel assistance, housing and home care services. Free copies are provided to injured workers. Call (413) 731-0760 or email us at comphurts@aol.com.

HEALTH INSURANCE AND OTHER MEDICAL RESOURCES

MassHealth (Medicaid)

333 Bridge St., Springfield, MA 01103
(800) 332-5545, TTY (800) 596-1276

If you lose your health insurance, you may be able to get coverage through MassHealth. Income, not assets, is used to determine your eligibility, so you will not be denied coverage because you own a home or have savings. MassHealth coverage includes prescriptions. They have several plans and eligibility rules are complicated. If you exceed their income limit, for example, you may still be eligible if you are a disabled adult working at least ten hours a week. MassHealth may place a lien on your workers comp benefits. Discuss with your attorney the ramifications of getting on MassHealth.

Medicare

Social Security Office, 1550 Main St. Springfield, MA 01103

(413) 785-0110

If you receive SSDI, you will be eligible for Medicare after two years. MassHealth may cover the costs that Medicare does not.

Massachusetts League of Community Health Centers
(800) 475-8455; www.massleague.org
If you have no health insurance, you can turn to these centers for primary and preventative health care, including dental and mental health. They also take insurance. BEWARE: Don't assume that you will not be billed because you are uninsured. Let them know you want to apply for free care.
Brightwood Health Center
380 Plainfield St., Springfield, 01107
(413) 794-4458
Mason Square Health Center
Springfield Southwest Community
Health Center
1038-50 Main St., Springfield, 01103
(413) 739-1100
Community Health Center
of Franklin County
338 Montague City Road
Turners Falls, 01376
(413) 772-3748
Worthington Health Center
Huntington Health Center
Holyoke Health Center
COBRA
Pioneer Valley Free Health Services
281 Maple St.
East Longmeadow, MA 01028
(413) 525-3866
Open Wednesdays from 6:30-8:30 p.m.
This is for the uninsured or underinsured. No appointment necessary.
Springfield Technical Community College (STCC) Dental Clinic
One Armory Square
Springfield, MA 01105
(413) 781-7822
Teeth cleaning, exam and x-rays for $30.
SHINE (Serving the Health Insurance Needs of the Elderly)
Information about health insurance and prescription drug programs. Not only for the elderly.
www.healthconsult.com
A patient-oriented medical website.
Health Care for All
30 Winter St. 10^{th Floor, Boston, MA 02108 (800) 272-4232}
Dentistry for All
www.pharmasave.com
Medical site/natural health supplement guide.
Hampshire Health Access
(413) 256-8448
This is a program for people who do not have health insurance and cannot afford medical care. It links participants with medical providers who offer services at reduced fees. The program also provides information about health care resources, including MassHealth, community health centers and prescription programs.
www.massmedboard.org
Massachusetts Board of
Registration in Medicine
560 Harrison Ave., Suite G4
Boston, 02118, MA
(617) 654-9800.
Look up information about your doctor! Search profiles of Massachusetts physicians, including their history of malpractice or discipline by a hospital or the board.
Joint Commission on Accreditation
of Healthcare Organizations
(800) 994-6610; www.jcaho.org
Office of Quality Monitoring
One Renaissance Boulevard
Oakbrook Terrace, IL 60181
Many hospitals are accredited by this commission. Contact them regarding a complaint.
www.questionabledoctors.org
A list of doctors who have been sanctioned by state medical boards.
www.coem.com
Information about chemical and environmentally triggered injuries.

56 Vernon St., Amherst, MA 01002
30 Winter Street, Suite 1010
Boston, MA 02108
(800) 342-8747
Hampden: (413) 827-7649
Franklin/Hampshire: (800) 498-4232
Berkshire: (800) 957-3557.. You may be able to extend your health insurance through your job for 18-36 months through COBRA coverage. COBRA can be expensive, however, as your employer no longer pays part of the premium. MassHealth may pay the premium.
230 Maple St., Holyoke, 01040
(413) 420-2200
73 Russell Road, Huntington, 01050
(413) 667-3009
58 Old North Road, Worthington, 01098
(413) 238-5511
11 Wilbraham Road, Springfield, 01109
(413) 784-3710

The Four Stages of a Contested Workers Comp Claim

If you are receiving a weekly check and your medical bills are being paid, you may expect everything to continue going smoothly. At some point, however, your case may be contested and have to be resolved at the Department of Industrial Accidents. Some cases are contested from the beginning, with the employer refusing to take any responsibility for the injury. In other cases, insurance companies wait to see if you will recover and return quickly to work. If you don't, they may contest the claim. You will receive a letter in the mail with the date and time that you must appear at your local office of the Department of Industrial Accidents.

Stage 1: Conciliation

Don't worry too much about this step. A conciliation is an informal meeting at which your lawyer, the insurance company's lawyer and a conciliator from the DIA try to reach an agreement about your claim. In most cases, you say nothing during the conciliation. In our experience, very few cases are resolved at this stage.

Stage 2: Conference

If nothing is resolved at the conciliation, your case advances to the conference. The letter that notifies you of your conference date will also tell you the name of the judge to which your case has been assigned. The name of the judge may be significant. Some judges are sympathetic toward people who are ill or injured; others have the same negative views of injured workers as the general population. They may be looking for malingerers or believe that "everyone can do something." Asked your lawyer or other injured workers to find out what type of judge is handling your case.