When you, or your attorney, files claim for benefits or the insurer files a complaint to stop or modify your benefits, a conciliation is scheduled. A conciliation is an informal meeting between you, your attorney, the insurer's attorney, and a conciliator from the DIA.
At the conciliation, the conciliator will attempt to help reach a voluntary agreement between you and the insurer. If a voluntary agreement can't be reached, the claim is referred to an administrative judge for a conference.
You will need to bring your most recent medical documentation with you. Medical documents need to be dated within the previous 6 months.
It is recommended your hire an attorney for a conciliation .
If your case gets referred to an administrative judge for a conference, it is strongly advised you hire an attorney.
Industrial Accident Board (IAB)
The Industrial Accident Board (IAB) is the central component of the Division of Dispute Resolution. If the parties involved in the workers' compensation case don't reach an agreement at conciliation, the case can be referred on to a conference before an administrative judge (AJ). There are 21 AJ's presiding over disputed workers' compensation cases from the conference proceeding to the hearing stage.
Conferences involve informal, non-evidentiary proceedings where each party (usually represented by an attorney) presents brief oral arguments and submits documents to support their side of the case. The AJ will issue a temporary order addressing the matter(s) in dispute. Either party may appeal the order and request a hearing.
Unlike the conference, the hearing is a formal proceeding where the contested issues are heard de novo (without regard to what happened at the conference) under the Massachusetts Rules of Evidence, and the prescribed Department of Industrial Accidents Regulations.
A court stenographer is assigned to record the hearing. After the hearing concludes, and all motions are ruled on and necessary depositions are filed, the AJ issues a formal hearing decision containing findings of facts and rulings of law.
The Reviewing Board is made up of 2 panels of 3 administrative law judges (ALJs). The panels function as the appellate body of the Department of Industrial Accidents. Decisions are formally published.
The reviewing board presides over:
- Lump sum settlements (MGL c. 152, § 48),
- Medical lien disputes (MGL c. 152, § 46A),
- Form 125 - Motion for Expedited Conference for reasons other than financial hardship,
- Reviews/approves Petition For Approval Of Third Party Settlement Under M.G.L. c. 152, Section 15 .
After the administrative judge renders a hearing decision, any aggrieved party can request review of the decision with the reviewing board. MGL c. 152, § 11C.
This appeal must be made within 30 days from the date of the hearing decision. The reviewing board may only reverse the decision of an administrative judge under certain limited circumstances, covered in MGL c. 152, §11C, which provides that reversals may be allowed if it is determined that the decision is:
- Beyond the scope of the judge's authority,
- Arbitrary or capricious, or
- Contrary to law.
The Reviewing Board may send a decision back to an administrative judge for further findings of fact when needed. Findings of witness credibility are made by the administrative judge following a hearing.
The reviewing board is empowered to affirm decisions summarily without discussion of the issues.
Oral arguments are scheduled at the discretion of the Reviewing Board, typically in cases of broad impact, but briefs must be filed on all appeals.
Practitioners looking to succeed on appeal should figure out if the Administrative Judge identified all issues and gave the grounds for the decisions made regarding each issue. The Administrative Judge must make clear findings of fact, particularly when there is conflicting testimony.
The procedures and requirements of appeals to the Reviewing Board are outlined in 452 CMR 1.15: Reviewing Board.
Impartial Scheduling Unit
The impartial scheduling unit is responsible for:
- Monitoring, and
- Managing impartial medical examinations.
- Filing fees,
- Schedules examinations, and
- Administers refunds.
The unit also maintains the roster of impartial physicians, who perform these examinations on behalf of the department. The impartial medical examination is the only medical evidence allowed at the hearing, unless the administrative judge rules otherwise.
The physicians on this roster meet the criteria of the Health Care Services Board, and are approved by the senior judge.
The operations unit is composed of several units: impartial scheduling, judicial support, and hearing stenographers.
Impartial scheduling is responsible for:
- Maintaining the schedules of the Administrative Judges (AJs) and Administrative Law Judges (ALJs),
- The distribution of board files,
- Specialized scheduling and processing requests, and
- Scheduling impartial medical exams.
Judicial support consists of the administrative assistants to the AJs and ALJs.
Hearing stenographers record verbatim testimony at hearings. They provide transcripts to:
- The Reviewing Board, and
- Case participants
The stenographers also record any additional proceedings that are conducted with the Division of Administration to include:
- Public hearings,
- Stop work order (SWO) hearings,
- Bidder/vendor conferences, and
- Insurance cancellations hearings (MGL c. 152, § 65B ).
Parties who would like to order a copy of their hearing transcript must send a written request to:
Omar Hernandez, Senior Judge
Department of Industrial Accidents
Lafayette City Center
2 Avenue de Lafayette
Boston, MA 02111-1750
You will be contacted when the transcript has been completed. You will receive a copy of your hearing transcript via e-mail. For more information please contact
Lafayette City Center
2 Avenue de Lafayette
Boston, MA 02111-1750
The administrative secretaries to the judges keep cases and files updated in the case management system (CMS) and on the document management system (DMS) for the proceedings of their assigned judges have heard. Medicals that are provided by outside parties are directed by the assistants to the impartial physician as required. Correspondence through e-mails and hard copy, if required, are maintained by the assistants on a daily basis. Interaction with other agency units is also done daily, as required.
Judicial nominating process
According to Executive Order 456 the process of identifying, screening and nominating candidates for the positions of Administrative Judge and Administrative Law Judge for the Department of Industrial Accidents (DIA) has been revised.
The new, detailed process is designed to ensure that this opportunity is given to all qualified men and women in the Commonwealth, and that the pre-eminent consideration for nomination is merit.
Consistent with these objectives, the DIA has established new procedures for all judicial applicants, including judges seeking reappointment.
Our goal is to provide an informative web-based portal through which applicants can become familiar with the application and nomination process. We welcome comments and suggestions on the policies and procedures. Please contact us at Info2@dia.state.ma.us.