Massachusetts Injury Report Form
Description
How to fill out Injury Report Form?
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FAQ
All employers operating in Massachusetts are required to carry workers' compensation insurance for their employees and themselves if they are an employee of their company. The requirement applies no matter the number of hours worked or the number of employees.
Weekly TTI payments are calculated as 60% of your average weekly wage before your injury or illness, subject to a maximum and minimum based on the statewide average weekly wage (SAWW) at the time of your injury. You'll receive the full amount of your pre-injury wages if they were less than the minimum.
File an Employer's First Report of Injury, Illness or Death (Form 101) online. The Department of Industrial Accidents (DIA) only accepts online filing of Form 101. Learn how to complete the form online.
You have 7 calendar days (except for Sundays and legal holidays) after the injured worker's 5th day of full or partial disability to report the injury to the DIA. You need to file the Form 101 - Employer's First Report of Injury/Fatality via a DIA online account.
What are the requirements for worker's compensation in Massachusetts? The state's workers' compensation statute is quite strict: every business with employees must carry workers' comp insurance. The only exemptions are for: Domestic service (household) employees who work less than 16 hours per week.
The general rule is that all injuries and illnesses which result from events or exposures on the employer's premises are presumed to be work related. Furthermore, if it seems likely that an event or exposure in the work environment either caused or contributed to the case, the case is considered work related.
You have 7 calendar days (except for Sundays and legal holidays) after the injured worker's 5th day of full or partial disability to report the injury to the DIA.