- Insurers are required to begin payment for lost wages or send a notice of denial to the employee within 14 days of receiving the Employer First Report of Injury -- With Instructions (Form 101) from the employer.
- Insurers may pay workers' compensation benefits to employees for up to 180 days without making a final decision on the case. This is referred to as the "Pay Without Prejudice" period.
- Insurers may increase the 180-day "Payment Without Prejudice" period, with the employees consent, for up to one year, by filing an Agreement To Extend 180 Day Payment-Without-Prejudice Period (Form 105) Agreement To Extend 180 Day Payment Without Prejudice Period - Form 105 with the Office of Conciliation.
- A Conciliator can approve the Agreement if it is determined that such as Agreement is not detrimental to the employee's case.
Please mail the signed, original Form 105, with a copy of both the Form 101 and 103, to:
Department of Industrial Accidents
1 Congress Street, Suite 100
Boston, MA 02114-2017
FAX: (617) 727-4366
Please contact Sandra Perez at 617-727-4900 x 4368 with any questions.
People also viewed...
You recently viewed...
Personalization is OFF. Your personal browsing history at Mass.gov is not visible because your personalization is turned off. To view your history, turn your personalization on.
Learn more on our .
*Recommendations are based on site visitor traffic patterns and are not endorsements of that content.