Report an occupational disease or injury

Reporting occupational injuries and diseases is required by 105 CMR 300.180. You should report cases should within 10 days of diagnosis or identification.

Occupational Health Surveillance Program

The Details of Report an occupational disease or injury

What you need for Report an occupational disease or injury

  • Your name, address and phone number
  • Your patient’s name, address, phone number, race, sex, date of birth, occupation
  • The employer’s name, location, and type of business where the exposure/injury occurred
  • The confirmed or suspected diagnosis
  • Date of diagnosis
  • The suspected hazard or exposure, if known

How to report Report an occupational disease or injury

You may report an occupational disease or injury by calling the Occupational Health Surveillance Program at (617) 624-5632.

  1. Download and complete the Occupational Illness and Injury Reporting Guidelines and Confidential Reporting Form
  2. Fax the completed form to (617) 624-5696
  1. Download and complete the Occupational Illness and Injury Reporting Guidelines and Confidential Reporting Form
  2. Mail the completed form to:

    DPH Occupational Health Surveillance Program
    250 Washington St.
    4th floor
    Boston, MA 02108

Next steps for Report an occupational disease or injury

What happens after a case is reported?

  • You may be contacted to see if immediate action is needed. In some cases, DPH may request patient medical records or other information, as authorized by law (105 CMR 300.191).
  • In some cases, the patient may be contacted for a telephone interview about the conditions at work that contributed to the disease or injury. Only patients who provide informed consent are interviewed.
  • Worksite follow-up may be initiated after considering:
    • Seriousness of the hazard
    • Number of similar cases
    • Advice of the reporting health care provider
    • The wishes of the patient
  • If appropriate, workplace evaluations will be conducted by a federal, state or local agency.
  • You will be informed of referrals or other efforts made on behalf of your patients to reduce workplace hazards.
  • Data are periodically summarized to identify industries and occupations in which workers are at risk.

Contact for Report an occupational disease or injury

Address
250 Washington St., 4th Floor, Boston, MA 02108-4619
Fax
(617) 624-5676
Confidential Reporting Fax (617) 624-5696

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