Janine Senatore, Claims Manager
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
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.
- 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