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  1. #1
    Join Date
    May 2012
    Posts
    4

    Default Mission Statement from the DIA

    Hello just to let every one know, Please do not think the Mass DIA Mission statement is accurate because it isn't. The statement say's we are entitled to Adequate health care, but I did not receive it even though my insurer said with an approval letter they were going to do the surgery for my shoulder they still made me wait 16 months for it by then the damage is done and now I have a loss of function Doe's any one feel that they can do something about it ? because well just like my attorney said their is nothing we can do about it. I wonder how many times this is going to happen until the state steps in and enforce their own laws about it, I guess they don't realize that every injured worker that waits for proper health care can and usually becomes a candidate for Disability all because of the insurer's negligence now the Social security system has to contend with that injured worker, because he/she cant go back out into the workforce. Wow what a miscarriage of justice. the system is broken and no one including the people can fix it.

  2. #2
    Join Date
    May 2012
    Posts
    4

    Default Re: Mission Statement from the DIA

    Is their any one out there that has read my statement about the DIA of massachusetts. That feels they can give me some advise on what to do about this matter, is there any thing I can do or am I STUCK

  3. #3
    Join Date
    Oct 1971
    Posts
    5,035

    Default Re: Mission Statement from the DIA

    topgun4167
    is there any thing I can do or am I STUCK
    Your attorney should have filed for an expedited hearing, don't know why it took 16 months to get medical.

    You could file a complaint with the Labor and Workforce Development (EOLWD)
    Start here:
    http://www.mass.gov/lwd/labor-relati...investigation/

    More info here:
    http://www.mass.gov/lwd/labor-relati...rocessing.html

    Not sure of what you're asking.
    Are you asking about delayed care causing further damage resulting in a permanent disability?
    If so, you did say they made you wait 16 months, meaning that your claim was accepted.
    Because your claim is accepted, the carrier would be on the hook for your continued medical care and wage loss so indirectly they do pay for their incompetence.

    You should be receiving Temporary Total Disability until you reach MMI.
    Benefits for Temporary Total Disability (TTD)
    The percentage of worker's wage paid is 60. For weekly payments, the minimum is $217.61 (20% of SAWW or worker's average wage, if less) and the maximum is $1,088.06, 100% of SAWW. The maximum period of payments is 156 weeks. An additional $6 will be added per dependent if weekly benefits are below $150.

    If you have reached MMI and have recieved a rating - you may be entitled to Permanent Partial Disability
    Benefits for Permanent Partial Disability (PPD)
    The percentage of worker's wage paid is 60% of the difference between the employee's AWW before injury and weekly wage earning capacity after injury. For weekly payments, the minimum is payable, but not statutorily prescribed and the maximum is 75% of the benefits the worker would receive for Temporary Total Disability. For non-scheduled injuries, the maximum period of payments is 260 weeks. The total number of weeks may be extended to 520 if it is found that the employee has suffered a permanent loss of 75% or more of bodily function or sense. Bulk sums are allowed for scheduled losses depending on the extent of loss. An additional $6 will be added per dependent if weekly benefits are below $150. WC benefits are subject to reduction by Unemployment Insurance and Social Security benefits.
    http://www.mass.gov/dia/


    Take Care
    Tony
    Last edited by tony; 05-30-2012 at 01:05 PM.
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

  4. #4
    Join Date
    May 2012
    Posts
    4

    Default Re: Mission Statement from the DIA

    Hello alright I will file a complaint but what does that get me. Because if the insurer is breaking the laws and not giving adequate health care and caused more harm than good, No injured worker should have to wait for a shoulder surgery (16 months) especially when the insurer has excepted the claim and sends the claimant two approval letters for surgery. I guess they are not going to be punished, I THINK THEY CALL THESE COURTESY LAWS. which the insurer will abided by them if they want to. I am screwed because I have lost my twenty plus year career of trucking. Doctors say my shoulder is junk I cant lift no more 10 lbs for the rest of my life. and the insurer is allowed to skate away from their obligations.

  5. #5
    Join Date
    Oct 2006
    Posts
    9,078

    Default Re: Mission Statement from the DIA

    delay of benefits may result in a penalty. you would need to file with the comp court.
    contact a workers comp atty in your area to file for you.

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