The hearing is a more formal proceeding held before the same administrative judge who presided at the conference. Massachusetts Rules of Evidence will apply and sworn testimony is taken. Witnesses are called and cross-examined by the opposing party. A stenographer records the proceedings. The judge may continue to gather information after the hearing.
The decision at a hearing can be appealed to the Reviewing Board by either party. The appeal to the Reviewing Board (Form 112) must be filed within 30 days of the issuance of the hearing decision. There is a fee equal to 30 percent of the state average weekly wage (at the time of the appeal) to appeal a hearing decision.
The reviewing board
This board is made up of six judges, three of whom will examine the hearing transcripts. They may ask for written briefs or oral arguments from either party. This panel can reverse or uphold the decision of the administrative judge.
Further appeals
Review Board decisions can be appealed to the Massachusetts Court of Appeals.
How your benefits are determined
Most benefits are based on your average weekly wage (AWW) prior to your injury (including overtime, tips, etc.), going back up to 52 weeks prior to your date of injury. If you have not been in your current job long enough to fairly determine your AWW, the insurer can use the actual wages of a co-worker who had been in a similar job as yours long enough to determine an AWW, or another method.
Medical benefits
You are entitled to adequate and reasonable medical care. You will also be paid mileage for travel to and from medical visits. For your first visit to the doctor or hospital your employer has the right to designate a health care provider within the employer's preferred provider arrangement. After that initial treatment, you have the right to choose your own health care providers. You may change these providers one time without the permission of the insurer. To change providers again you will need the insurer to agree to the change. The insurer has the right to send you to see its doctor for an evaluation of your incapacity.
Temporary total incapacity benefits
You qualify for total temporary benefits if your injury leaves you unable to work, considering your age, training, and experience, for six or more calendar days (the days do not have to be consecutive). You can receive these benefits for up to 156 weeks. Compensation begins on the sixth day of incapacity; you will not be compensated for the first five days of incapacity unless you are disabled for 21 days or more. Again, these days do not have to be consecutive.
Temporary total benefits are based on your gross earnings over the 52 weeks prior to your injury. To determine your benefits, take your actual gross earnings, including overtime, bonuses, etc., and divide this number by the number of weeks you worked, in order to compute your average weekly wage. Multiply that number by 60 percent (.60) and you will come up with your approximate weekly compensation. The maximum that you can receive is the state's average weekly wage (SAWW) at the