If you have a work-related injury or illness which results in lost work time of five full or partial calendar days or more, your employer must file the Employer's First Report of Injury or Fatality - Form 101 with the DIA and their workers' compensation insurance company within seven calendar days (not including Sundays and legal holidays) from the fifth full or partial calendar day you have been disabled because of the injury or illness. The insurance company has 14 calendar days from when they receive this form from your employer to investigate the claim and make a decision as to whether to pay the claim or not.

Please Note: If your employer does not send the Employer's First Report of Injury or Fatality - Form 101 to the insurer, you should report the injury in writing to the insurance company yourself or complete the DIA's Employee's Claim - Form 110 and send the insurer a copy of the completed form. Your employer should have a poster displayed in the workplace with the name and address of its workers' compensation insurer and policy information. If your employer does not have this poster displayed and will not tell you the name of its insurance company, the DIA's Office of Insurance at 617-626-5480 or 617-626-5481 and they will try to help you.