How to File a Workers' Compensation Claim in Massachusetts

Learn when and where to initiate your Massachusetts workers' comp claim.

If you have suffered an occupational injury or illness in Massachusetts, you may be eligible for workers’ compensation benefits. Workers' comp covers medical treatment, pays compensation for wage loss, and provides other important financial assistance. To collect benefits, you must meet certain requirements, including reporting your injury to your employer within a certain time frame.

How Does the Massachusetts Workers’ Compensation System Work?

In Massachusetts, most employers must have workers’ compensation coverage—either by purchasing a workers’ comp policy from a private insurance company or by receiving certification from the state to self-insure. (In general, only large, financially stable employers will qualify to self-insure.) The  Massachusetts Department of Industrial Accidents  (DIA) oversees all workers’ comp claims in the state.

Like all other states, Massachusetts has a no-fault workers’ compensation system. You do not need to show that your employer acted carelessly in order to receive benefits. As long as your injury happened on the job or was caused by your work activities, you will typically be eligible for benefits.

Eligible workers may receive a variety of benefits, including:

  • temporary incapacity benefits (payments for wage loss)
  • compensation for permanent loss of bodily function or disfigurement
  • reasonable and necessary medical care, and
  • vocational rehabilitation (training or education for a new line of work).
To learn more about these benefits, see  Types of Workers' Compensation Benefits.

How Do I Report an Injury?

Notifying your employer is the first step to starting your workers’ compensation claim. In Massachusetts, you must promptly notify your employer of a work-related injury, either orally or in writing. Written notice is typically best though, as it creates a record that you fulfilled the notice requirement. If you fail to notify your employer promptly, you may lose the right to collect benefits.

It is important to provide notice and get medical treatment as quickly as possible. Employers and insurance companies are skeptical of delayed claims and tend to deny them. Giving notice and getting treatment early on will reduce the likelihood of a claim denial.

When you notify your employer, provide as much detail as possible, including:

  • when the accident happened
  • how you hurt yourself, and
  • what symptoms you are experiencing.

Your employer may also ask you to fill out a written accident report. When completing the report, be as accurate as possible. Accident reports are frequently used as evidence in disputed claims, and any inconsistencies may be used against you.

After you give notice, your employer should tell you how to get medical treatment. Your employer has the right to select a doctor to provide your initial treatment. After that, you may select your own doctor. It is important to provide your doctors with accurate information about the cause of your injuries and the severity of your symptoms. Accurate information should help your doctor diagnose your condition and provide appropriate medical care—which may lead to a quicker recovery.

What Happens After I Report My Injury?

Once you report an occupational injury or disease, your employer typically will file an Employer’s First Report of Injury or Fatality with its insurance company and the DIA. If your employer refuses to notify its insurer, you should file an Employee’s Claim (Form 110) with the insurance company and the DIA.

The insurance company will then determine your eligibility for benefits. Its investigation may involve:

  • reviewing your medical records
  • analyzing your work experience, education, and wages
  • ordering a medical examination to assess your condition, and
  • sending you for a functional capacity evaluation (an assessment of your ability to perform work duties).

Under Massachusetts law, the insurance company must either approve or deny your workers’ compensation benefits within 14 days of receiving notice of your injury. If your claim is approved, you will start receiving disability payments and other benefits. Unfortunately, insurance companies deny many workers’ compensation claims. (For common grounds for a denial, see  Denied Workers' Compensation Claims.)

Do I Need to File a Workers’ Compensation Claim?

If the insurance company voluntarily pays your workers’ compensation benefits, you do not need to file a formal claim with the DIA. However, if your claim is denied, you have the right to appeal the insurance company’s decision. To begin the process, you must file an Employee’s Claim (Form 110) with the DIA. This claim must be filed within four years of one of the following:

  • the date of your injury
  • the date you discovered that your medical condition was work-related, or
  • the date you received an Insurer’s Notification of Denial (Form 104).

Unless your claim is very simple, you should consider hiring a workers’ compensation lawyer. The insurance company will have a lawyer and you may be at a disadvantage if you proceed without an attorney.

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