The Department of Industrial Accidents (DIA) is required by law to fine those employers who have not filed an Form 101 - Employer's First Report of Injury/Fatality  within the statutory time limits. YOU MUST EITHER PAY OR APPEAL WITHIN 30 DAYS. Please mail payments to:

Department of Industrial Accidents
P. O. Box 3732
Boston, MA 02241-3732

If you receive an Employer Injury Report Violation Notice - Form Letter 60 from the DIA, and believe that it is not warranted, this is the protocol to appeal it:


All inquiries/appeals must be submitted in writing along with a copy of the violation invoice. Briefly state in a letter the reasons you believe that you are not liable for this fine. You must do this within 30 calendar days from the date of the notice. Include all RELEVANT information.

Appeals should be sent to:

Dept. of Industrial Accidents
First Report Appeals
1 Congress St., Suite 100
Boston, MA 02114-2017


The DIA will conduct an individual administrative review of your appeal. This means that we will research and/or pull the original forms from our files and confirm the basis for the original issuance of the fine. If the research and review supports your contention, we will take corrective action to withdraw the violation. You will be notified in writing of the DIA's decision.


If you are not satisfied with the result of this administrative review, you have the right to request a formal hearing by the DIA within 14 calendar days of receiving our decision. You will be notified of the date, time and place of this hearing.

Please Note: If you do not pay the fine or appeal your original violation, additional violations on your account will be incurred. Department regulations (452 CMR 1.03 (3) (C)) do not provide for any appeal to Demand Notices - Form Letter 420. The fine is due within 14 calendar days of receipt of the administrative review. Only one administrative review is allowed for each violation.