As the employer, it is important that you file the Form 101 - Employer's First Report of Injury/Fatality  accurately and timely, otherwise you may receive a First Report Violation Notice from the Department of Industrial Accidents (DIA). The reasons for receiving this First Report Violation Notice are many, and the most common reasons are:

1. The First Report is filed late.

2. The employer erroneously does not file an Employer's First Report of Injury or Fatality - Form 101 with the DIA and only files with their insurance agent or company.

3. The employer receives a rejected form back from the department, and does not re-file the rejected form with the needed corrections.

4. The insurer sends the department either a Form 103 - Insurer's Notification of Payment or a Form 104 - Insurer's Notification of Denial  in response to a report from an employer that should have been filed as a medical-only claim.

5. The DIA has made an error.

Recommended Content

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.