If you wish to present a Lump Sum Agreement to the Boston Office of Conciliation or any Regional Office for review and approval by a Conciliator, the process is a simple one:
- While no appointment is necessary, it may be best to call the Regional Office to schedule a Lump Sum Conference.
- Please bring 3 copies of the signed Lump Sum Agreement, the signed Employer Consent To Lump Sum Agreement (Form 116A) , the signed Form 116B - Addendum to Lump Sum Agreement: Vocational Rehabilitation Status Lien Disclosure Form (Form 116C) Vocational Rehabilitation Status - Form 116B, and the signed Lien Disclosure - Form 116C.
- The employee (and his attorney) and the insurer must be present at the Lump Sum Conference.
The Office of Conciliation cannot review and approve Lump Sum Agreements with undischarged liens (such as liens for child support, welfare, probate, etc.) or where the case is currently pending before an Administrative Judge.
Please be advised that the Office of Conciliation can only approve Lump Sum Agreements for completeness as to form and cannot consider whether the agreement is "in the employees' best interest". MGL c. 152 §48
If you have any questions regarding the review or approval of a lump sum agreement by the Office of Conciliation, please contact:
Department of Industrial Accidents
1 Congress Street, Suite 100
Boston, MA 02114-2017
FAX: (617) 727-4366