HOUSE DOCKET, NO. 1279 FILED ON: 2/4/2021
HOUSE . . . . . . . . . . . . . . . No.
The Commonwealth of Massachusetts
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PRESENTED BY:
Tackey Chan
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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act relative to worker’s compensation insurance.
_______________
PETITION OF:
NAME: DISTRICT/ADDRESS: DATE ADDED:
Tackey Chan 2nd Norfolk 2/4/2021
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 HOUSE DOCKET, NO. 1279 FILED ON: 2/4/2021
HOUSE . . . . . . . . . . . . . . . No.
[Pin Slip]
[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE HOUSE, NO. 1598 OF 2019-2020.]
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Second General Court
(2021-2022)
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An Act relative to worker’s compensation insurance.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 SECTION 1. Chapter 152 of the General Laws is hereby amended by inserting after
2 section 7G the following section:-
3 Section 7H. In any claim for compensation by an employee, which is denied by an
4 insurer or self-insurer, no photograph or video of the claimant or the claimant’s immediate
5 family shall be admissible in evidence or referred to at the hearing of any such claim, or in any
6 proceeding connected therewith, if it was obtained without the claimant’s written consent.
7 SECTION 2. Section 8 of said chapter 152, as appearing in the 2016 Official Edition, is
8 hereby amended by striking out subsection (1) and inserting in place thereof the following
9 subsection:-
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10 (1) An insurer which makes timely payments pursuant to subsection 1 of section 7, may
11 make such payments for a period of 180 calendar days from the commencement of disability
12 without affecting its right to contest any issue arising under this chapter. An insurer may not
13 terminate or modify payments at any time within such 180 day period without an order or
14 decision of an arbitrator, an administrative judge, the reviewing board or court of the
15 commonwealth modifying or discontinuing compensation.
16 Any failure of an insurer to make all payments due an employee under the terms of an
17 order, decision, arbitrator's decision, approved lump sum or other agreement, or certified letter
18 notifying said insurer that the employee has left work after an unsuccessful attempt to return
19 within the time frame determined pursuant to paragraph (a) of subsection (2) of this section
20 within 14 days of the insurer's receipt of such document, shall result in a penalty of $200 dollars,
21 payable to the employee to whom such payments were required to be paid by the said document;
22 provided, however, that such penalty shall be $1,000 dollars if all such payments have not been
23 made within 45 days, $2,500 dollars if not made within 60 days, and $10,000 if not made within
24 90 days. No penalty shall be assessed a self-administered public employer or the Workers'
25 Compensation Trust Fund under this paragraph where delivery has been made to the employee or
26 other recipient of a copy of an official request made by such employer or fund to the appropriate
27 authority for the issuance of a check in the appropriate amount to said recipient, provided that
28 delivery of such copy to said employee or recipient has been made within 14 days of the
29 employer or fund's receipt of the order, decision or agreement.
30 SECTION 3. Subsection 2 of said section 8 of said chapter 152, as so appearing, is
31 hereby amended by striking out clause (d) and inserting in place thereof the following clause:-
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32 (d) the insurer has possession of (i) a medical report from the treating physician which
33 indicates that the employee is capable of return to the job held at the time of injury, or other
34 suitable job pursuant to section 35D consistent with the employee's physical and mental
35 condition as reported by said physician and (ii) a written report from the person employing said
36 employee at the time of the injury indicating that such a suitable job is open and has been made
37 available, and remains open to the employee; provided, however, that if due, compensation shall
38 be paid under section 35D; provided, further, that if such employee accepts said employment
39 subsequent to a modification or termination pursuant to this paragraph, compensation shall be
40 reinstated at the prior rate if the employee should cease work in accordance with paragraph (c) of
41 this section or should be terminated by the employer because of the employee's physical or
42 mental incapacity to perform the duties required by the job;
43 SECTION 4. Said section 8 of said chapter 152, as so appearing, is hereby amended by
44 striking out, in line 153, the words “a conciliator,” and inserting in place thereof the following
45 word:- an.
46 SECTION 5. Said chapter 152, as so appearing, is hereby amended by striking out
47 section 10 and inserting in place thereof the following section:-
48 Section 10. Any claim for benefits shall be filed with the division of administration and
49 the insurer on a form prescribed by the division, and shall specifically state the benefits claimed
50 to be due and unpaid. No claim for weekly compensation shall be accepted by the department
51 unless it is either accompanied by a copy of an insurer's notification of denial pursuant to section
52 7, or at least 30 days have passed from the alleged onset of disability.
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53 Unless otherwise expressly provided, on the receipt of a claim for compensation, a
54 complaint from the insurer requesting a modification or discontinuance of benefits, or a
55 complaint from any party requesting resolution of any other issue arising under this chapter, the
56 division of administration shall notify the parties that it is in receipt of such claim or complaint,
57 and may request the parties to appear and submit relevant information.
58 In order for an attorney's fee to be required pursuant to section 13A, due to a dispute over
59 a claim for benefits under this chapter, such claim shall have been sent to the insurer by certified
60 mail. No attorney's fee shall be due for services involving a claim sent to the insurer which does
61 not include a copy of a medical report relevant to the alleged claim in the possession of the
62 employee or his attorney. In order for any attorney's fee to be due for services involving a claim
63 for health care services, such claim shall include a copy of any relevant bill and a description
64 from the health care provider of the services rendered. No attorney's fee shall be due for services
65 involving claim for benefits for loss of function or disfigurement under section 36 unless such
66 claim includes a copy of a letter from a physician describing the location and extent of the
67 alleged loss of function or disfigurement and the specific amount requested for compensation
68 therefor. No attorney's fee shall be due for services involving claims for mileage reimbursement
69 unless such claims delineate the date and purpose for the travel, identity of the medical provider
70 and mileage of each trip for which reimbursement is sought. No attorney's fee shall be due for
71 any claim solely involving unpaid attorney's fees or expenses for past services.
72 SECTION 6. Section 10A of said chapter 152, as so appearing, is hereby amended by
73 striking out subsection (2) and inserting in place thereof the following subsection:-
74 (2) Within 7 days of the conclusion of the conference the administrative judge shall file:
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75 (a) a written order requiring or denying that weekly compensation or other benefits be
76 paid; or
77 (b) a written order modifying, terminating, or denying modification or termination of
78 weekly compensation or other benefits.
79 Whenever the subject of the conference is a claim or complaint for which written offers
80 have been filed pursuant to section 10, the order or arbitrator's award modifying, terminating, or
81 denying modification or termination of weekly compensation benefits shall reflect the amount so
82 filed by one or other of the parties, and shall not require any payment, modification or
83 termination which has not been proposed by either party unless the judge or arbitrator provides a
84 detailed written explanation of why neither submitted amount could reasonably be believed to
85 accurately compensate the employee for his earning capacity. Whenever, with respect to a case
86 in which liability is not an issue, a claim for additional compensation or a complaint to
87 discontinue or modify compensation is among the issues before the administrative judge or
88 arbitrator, if written amounts are unavailable on the date of the conference or arbitration for any
89 reason, the administrative judge or arbitrator shall require or, in case of newly discovered
90 information, allow such filings at the close of the conference or arbitration, and the order or
91 award shall reflect one of the offers so filed and not substitute any other amount unless the judge
92 or arbitrator provides a detailed written explanation of why neither submitted amount could
93 reasonably be believed to accurately compensate the employee for his earning capacity.
94 Nothing in this section shall restrict the authority of an administrative judge to order
95 weekly benefits or health care services for a closed period into the future or to order that such
96 benefits or services be initiated, modified, or terminated at a particular date in the future.
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 97 SECTION 7 . Subsection (1) of section 10C of said chapter 152, as so appearing, is
98 hereby amended by striking out, in line 9, the words “ mediation and conciliation” and inserting
99 in place thereof the following words:- “and mediation.”
100 SECTION 8. Section 11A of said chapter 152, as so appearing, is hereby repealed.
101 SECTION 9. Section 13A of said chapter 152, as so appearing, is hereby amended by
102 striking out subsections (1) to (4), inclusive, and inserting in place thereof the following 4
103 subsections:-
104 (1) Whenever an insurer contests an initial liability claim for benefits submitted on a form
105 prescribed by the department, by failing to commence the compensation requested within 21
106 days of receipt of such claim, and then, at any time prior to a conference held under section 10A,
107 the insurer agrees to pay, with or without prejudice, the compensation claimed to be due, said
108 insurer shall pay an attorney's fee to the employee's counsel in the amount of $700 dollars, plus
109 necessary expenses; provided, however, that only 1 such fee shall be paid with respect to any
110 such written claim under this paragraph.
111 (2) Whenever an insurer contests an initial liability claim for benefits as provided by
112 subsection (1), and then is ordered to pay such benefits by an administrative judge pursuant to a
113 conference held under section 10A, said insurer shall pay an attorney's fee to the employee's
114 counsel in the amount of $1,000, plus necessary expenses; provided, however, that an
115 administrative judge may increase or decrease such fee based on the complexity of the dispute or
116 the effort expended by the attorney; provided, further, that only 1 such fee under this paragraph
117 shall be paid with respect to any such written claim.
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118 (3) Whenever an insurer contests a claim for benefits on a form prescribed by the
119 department other than an initial liability claim as provided by subsection (1), by failing to
120 commence the compensation requested within 21 days of receipt of such claim and then, at any
121 time prior to a conference pursuant to section 10A the insurer agrees to pay the compensation
122 claimed to be due, said insurer shall pay an attorney's fee to the employee's counsel in the
123 amount of $500, plus necessary expenses; provided, however, that only 1 such fee shall be paid
124 with respect to any such written claim under this paragraph. For purposes of this subsection, the
125 filing of a subsequent written request on a prescribed form shall be deemed an additional written
126 claim for benefits.
127 (4) Whenever an insurer files a complaint to reduce or discontinue an employee's benefits
128 or whenever an insurer contests a claim for benefits on a form prescribed by the department other
129 than an initial liability claim as provided by subsection (1), by failing to commence the
130 compensation requested within 21 days of receipt of such claim, if the order of the administrative
131 judge pursuant to a conference held pursuant to section 10A, reflects the written offer submitted
132 by the claimant, pursuant to section 10 or section 10A, said insurer shall pay an attorney's fee to
133 the employee's counsel in the amount of $700, plus necessary expenses. If the order of the
134 administrative judge reflects the written offer submitted by the insurer, pursuant to section 10 or
135 section 10A, no attorney's fee shall be payable to the employees' counsel. If the order reflects an
136 amount different from both submissions, the fee shall be in the amount of $350, plus necessary
137 expenses. Only 1 such fee shall be paid with respect to any particular written claim under this
138 paragraph.
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139 SECTION 10. The first paragraph of section 30 of said chapter 152, as so appearing, is
140 hereby amended by striking out the first sentence and inserting in place thereof the following
141 sentence:-
142 The insurer shall furnish to an injured employee adequate and reasonable health care
143 services, including physical therapy at the injured employee’s request, and medicines if needed,
144 together with the expenses necessarily incidental to such services, and in the case of an injured
145 employee, a physical examination shall be given at least once a year while the employee is
146 hospitalized.
147 SECTION 11. The first paragraph of section 48 of said chapter 152, as so appearing, is
148 hereby amended by striking out the last 2 sentences and inserting in place thereof the following
149 sentence:-
150 In all other cases the agreement shall not have been perfected until reviewed and
151 approved as complete by an administrative judge or administrative law judge as appropriate.
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