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  • Ma 160 2019

Get Ma 160 2019-2026

The Commonwealth of Massachusetts Department of Industrial AccidentsFORM 160Lafayette City Center, 2 Avenue de Lafayette, Boston, MA 021111750 Info. Line (800) 3233249 Inside Mass. / (857) 3217470.

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How to fill out the MA 160 online

The MA 160 form is an important document required by the Commonwealth of Massachusetts for industrial accidents. Properly filling out this form is essential for presenting your biographical data and medical information effectively during a hearing.

Follow the steps to complete the MA 160 online.

  1. Press the ‘Get Form’ button to access the MA 160 document and open it in your chosen application.
  2. Begin by providing employee biographical data. In the designated fields, enter the employee’s name, social security number (optional), home telephone number, number of dependents, home address, and personal details such as date and place of birth, date U.S. domicile was established, marital status, spouse's name and occupation, and information about children.
  3. Proceed to the education section. Record the name and address of the last school attended as well as the highest grade completed or date of graduation. Additionally, list any special skills or training received.
  4. Complete the military service section by specifying the branch of service and rank, along with the dates of service and military occupation or specialty.
  5. In the work history section, list previous employers starting with the most recent. Fill in the employer's name, employment dates, and job description for each position held. Include as many previous employers as necessary, following the same format.
  6. Fill out the medical data related to the industrial injury by providing dates and places of the first medical treatment, names of treating physicians, and dates of those treatments in chronological order.
  7. Document any outpatient or inpatient hospital treatments, specifying the dates and locations for each.
  8. List any hospital records or physician reports that will be submitted as evidence, ensuring you attach these documents as needed.
  9. Once all sections are completed and reviewed for accuracy, save your changes. You can then choose to download, print, or share the form as required.

Complete your documents online with confidence and ensure you have all required information ready for your hearing.

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