1.02: Definitions

Actual Employment as used in MGL c. 152 and 452 CMR 1.00 Adjudicatory Rules shall include any job for which the employee receives earnings.

Additional Compensation as used in MGL c 152,8(5) , shall mean compensation due pursuant to an order or decision finding that prior compensation was illegally discontinued.

All Payments Due an Employee as used in MGL c. 152,8(1) , shall mean, in regard to past due or retroactive benefits only, the sum certain payable to the employee after the determination of the amount due a lien holder in satisfaction of any lien filed pursuant to MGL 152,46A . Unless otherwise agreed, the parties shall make reasonable efforts to expedite the determination of the amount due the MGL c. 152, 46Alien holder, but in no event shall payment be delayed beyond 60 days of the insurer's receipt of the order, decision, arbitrator's decision, approved lump sum or other agreement indicating that such payments are required to be made. All other payments due an employee shall be made by the insurer within the timeframe set forth in MGL c. 152,8(1).

Amount Payable to the Employee Within the First Month from the Date of the Voluntary Payment, Order or Decision as used in MGL c. 152,13A(10), shall mean any future benefits pursuant to MGL c. 152 due the employee for the first 30 days subsequent to the date of execution of a voluntary payment or the issuance of an order or decision.

Cash Award as used in MGL 152,13A(10), shall mean any benefits payable under MGL c. 152,36 or MGL c. 152,36A and any weekly benefits payable under MGL c. 152 of an amount that exceeds the weekly amount being paid the employee for the week immediately prior to the date of the voluntary payment, order or decision.

Disputes Over Medical Issues , as used in MGL c. 152,11A(2) , shall not include any case in which:

(a) the parties disagree solely regarding the entitlement to weekly benefits concerning a specific period or periods of disability, or death, which occurred prior to the hearing scheduled pursuant to MGL c. 152,11;

(b) the parties disagree regarding the liability of the named insurer for any claimed injury; provided, however, that the parties agree that no impartial physician's report is required;

(c) the parties agree upon both the nature of the impairment and the causal relationship between the impairment and the employment; provided, however, that the parties agree that no impartial physician's report is required.

(d) based upon the information submitted at a Conference pursuant to MGL c. 152,10A, the administrative judge determines that there is no dispute over medical issues. The judge's determination, and reasons therefor, shall be stated in the MGL c. 152,10A Conference order.

Factual Basis for an Insurer's Refusal to Pay Compensation as used in MGL c. 152,7 and MGL c. 152,8, shall be a short and plain statement of the specific facts supporting the grounds for said refusal.

Filed as used on MGL c. 152,10A and MGL c. 152,11C as used in 452 CMR 1.11(1) 452 CMR 1.11: Hearings 452 CMR 1.15(1) and 452 CMR 1.15: Reviewing Board shall mean placement of the appeal in the mail to the Department postmarked, or sent electronically, no later than midnight on the 14th day when appealing a conference order under MGL c. 152,10A, and the 30th day when appealing the decision of an administrative judge pursuant to MGL c. 452,11C. Unless otherwise indicated, where the words "file" or "filed" appear, they shall mean through the placement in the email or electronic transmittal to the Department.

Insurer as used in MGL c. 152,45 shall include the Workers' Compensation Trust Fund.

Interest as used in as used in MGL c. 152,50, shall be calculated using the Department-provided formula available on its website. The parties may utilize other formulas but when a discrepancy exists the amount of interest in the Department formula will prevail for all purposes.

Mid-term Notice of Cancellation as used in MGL c. 152,55A, shall mean any notice of policy discontinuance during the term of the policy where such discontinuance is initiated by the insurer, and shall not include discontinuances initiated by insured's.

Necessary Expenses as used in MGL c. 152,13A, shall mean all reasonable out-of-pocket costs, as the Department may set, to a claimant's attorney incurred by said attorney in prosecuting a claim for benefits or contesting a complaint filed by the insurer, including the cost of obtaining relevant medical records, doctor's reports, private investigator fees, constable charges, expert witness charges, interpreter fees and scientific testing costs, but specifically excluding telephone expenses, parking fees, postage, stationery, photocopies, meals, automobile expenses, and ordinary legal office overhead. Filing fees and impartial physician deposition costs required by MGL c. 152,11A, which are paid by claimant's counsel, shall not be submitted as necessary expenses but shall be reimbursable directly from the insurer against whom the claimant prevails at hearing.

Toll as used in MGL c. 152,41, shall mean permanently satisfies.