If you are injured on the job
- Immediately notify your employer that you have been injured.
Employer HR/Workers’ Compensation Contact: Manager of Leaves/ADA Compliance
Phone Number: (617) 742-8575
- Tell the medical provider that you have been injured at work and give the information below:
Insurance Carrier: The Commonwealth of Massachusetts
Address: One Hundred Cambridge St., Suite 600, Boston, MA 02114
Phone Number: (617) 878-9809
Employer: Massachusetts Trial Court
Address: 2 Center Plaza, 9th Fl, Boston, MA 02108
- If the employer fails to report the injury to the insurer, the employee may file an Employee’s Claim (Form 110).
- Additional information regarding your rights and eligibility for benefits pursuant the Workers’ Compensation law may be obtained by contacting the Department of Industrial Accidents at (617) 727-4900.
If medical treatment is needed
Injured workers may select their own medical provider. Medical treatment costs that are reasonable, necessary, and related to the work injury will be paid by the above-named insurer.
If medical facility information is provided below, the above-named insurer has a preferred provider arrangement and the insurer has arranged for your initial treatment there.
Employer: This notice must be filled out and posted where employees can read it pursuant to Massachusetts General Law chapter 152, sections 21, 22, 30, and 75b (2). Employers may not retaliate, discriminate (in accordance with any applicable state or federal laws which includes immigration status), or provide false information about the workers’ compensation process to their employees. This notice must be updated, posted and redistributed when there are changes to the information.
Translations
This notice is available in Arabic, Cape Verdean, Chinese, French, Haitian Creole, Khmer, Portuguese, Spanish, and Vietnamese.
Agency contact
Department of Industrial Accidents
1 Congress Street, Suite 100, Boston, MA 02114
(617) 727-4900