Often times, injured workers who are receiving Massachusetts workers’ compensation benefits are mailed a form titled “Form 105 – Agreement to Extend the 180 Day Payment Without Prejudice Period.” Workers’ compensation insurers may send this form to an injured worker who has not yet retained an attorney in hopes of getting the unrepresented injured workers to sign the form without fully understanding the ramifications of doing so. It is usually sent to the injured worker during the 3rd to 5th month of disability following a work injury.
Signing the Agreement to Extend 180 Day Payment Without Prejudice Period form sent to you by the workers’ compensation insurer can have an extremely negative impact on your claim.
Insurance companies will send you this form under the guise that they are doing you a favor and agreeing to pay you for another 180 days, however by signing this form you are giving up legal rights and you may expose yourself to allowing the insurer to legally terminate benefits and put you in the position where you could go many months with no benefits while you fight the insurance company in court. In order to fully understand why singing this form can have negative consequences for an injured worker, it would be helpful to explain exactly what the 180 Day Payment Without Prejudice Period is.
THE FIRST 180 DAYS AFTER DISABILITY BEGINS
If the insurer has commenced benefits timely, namely within 14 days of notice, the insurer is allowed to stop payments to the employee without obtaining approval of the DIA or the consent of the employee. However the insurer is required to give the employee seven(7) day written notice of their intent to stop benefits. The insurer’s written notice of termination must state their reasons and advise the employee of his or her rights to file a claim for further benefits. Continue reading