Appeal a workers' compensation first report violation notice

Follow these steps to appeal a first report violation notice from the Department of Industrial Accidents (DIA).

Janine Senatore, Claims Manager

The Details

What you need

The DIA fines employers who don’t file a Form 101 - First Report of Injury/Fatality within the time frame specified by the workers’ compensation law. If you think the report violation is in error, you should  gather all supporting documents, including:

  • Physical or electronic date stamps on documents
  • Witness statements
  • The date you were notified of the injury

 

How to appeal

You must either pay or appeal a first report violation notice within 30 calendar days.

  • All appeals must be made in writing with a copy of the violation notice
  • Briefly state the reasons you believe the fine was issued in error
  • Include all relevant information and send everything to:

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

 

Next steps

Review and decision

The DIA will conduct an administrative review of your appeal.

  • If the review supports your appeal, we will withdraw the violation
  • If the review upholds the fine, payment is due within 14 calendar days of the review

If you aren’t satisfied with the decision, you have the right to request a formal hearing within 14 calendar days.

You will be notified of the date, time and place of the hearing.

More info

  • If you do not pay or appeal your original violation, additional violations on your account will be incurred
  • You can’t appeal a Demand Notice
  • Only one administrative review allowed per violation

Contact

Address

1 Congress St., Suite 100, Boston, MA 02114

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