When you have been unable to earn full wages for five (5) or more full or partial calendar days due to an injury on the job, your employer has seven (7) days, not including Sundays and legal holidays, from the fifth date of loss, to report the injury to its insurance company. The insurance company then has 14 calendar days from receipt of the first report of injury to mail you a check or, if it intends to contest the claim, to send you a form stating its reasons for denying compensation. An Employee Claim - Form 110 may be filed with the insurance company at any time, but the Department of Industrial Accidents (DIA) cannot accept it until at least 30 calendar days have passed since your first date of disability, or accompanied with an Insurer's Notification of Denial - Form 104. You can obtain claim forms from this website or call the Public Information Office at 617-727-4900, ext. 7470 to have one mailed to you. You may also e-mail the Public Information Office at and we can e-mail you the form.