Get Ma 160 2010

The MA 160 form is an essential document required by the Commonwealth of Massachusetts for employees preparing for a hearing. This guide provides a clear and supportive overview of how to complete this form online, ensuring that users can accurately present their information.

Follow the steps to successfully complete the MA 160 form online.

1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the employee's name in the designated field. Make sure to include the last name, first name, and middle initial if applicable.
3. Fill in the social security number field. Note that providing this information is optional, but it can aid in the processing of your forms.
4. Next, enter the home telephone number of the employee. This information will be useful for communication regarding the hearing.
5. Complete the home address section, ensuring all parts—number, street, city, state, and zip code—are accurately filled in.
6. Provide the date of birth, as well as the place of birth in the next fields.
7. Indicate when the U.S. domicile was established. This is crucial for jurisdictional purposes.
8. Select the marital status from the provided options. This information is relevant to your dependency claims.
9. Enter the spouse's name and occupation if applicable, as well as the names and ages of any children, attaching additional sheets if necessary.
10. In the education section, provide the name and address of the last school attended, high school graduation date or highest grade completed, and any special skills or training received.
11. Complete the military service section by listing the branch of service, rank, dates of service, and military specialties.
12. In the work history section, begin with the most recent employer and provide the employer's name, dates of employment, and a detailed job description, repeating this for previous employers as necessary.
13. Fill out the medical data related to any industrial injuries, including the date of first medical treatment and locations of treatment. List treating physicians and relevant treatments chronologically.
14. Document any outpatient or inpatient hospital treatments in the appropriate sections, providing detailed information and dates.
15. Finally, if there are any hospital records or physician reports to be included as evidence, be sure to list them in the designated area.
16. Once you have completed all sections, review the form for accuracy. You can then save your changes, download, print, or share the form as needed.

Complete your MA 160 form online today to ensure your information is ready for the upcoming hearing.