More information on workers' compensation for attorneys

If you have questions that aren't answered in the attorneys section, please check here.

Hardship requests

Requests that conference dates be scheduled sooner, due to a financial hardship on the part of an employee, are filed on the Request For A Speedy Conference Because Of Hardship - Form 131 and Affidavit in Support Of Request For A Speedy Conference Because Of Hardship - Form 132.

Requests for additional information can be obtained from the Senior Judge's Office, (857) 321-7307. Requests to expedite a date for a Hearing should be made by motion to the judge handling the case.

Motions for expedited conferences can also be made on the basis of fraud, illegal discontinuance of benefits, catastrophic injury, medical emergency, or denial pursuant to MGL c. § 15A. Motions are filed to the attention of the Reviewing Board Motion Clerk.

Changing the location of a conciliation

Request to move conciliations must be made in writing by the moving party to:

    Dele Edebiri
    Conciliation Manager
    Department of Industrial Accidents
    Lafayette City Center
    2 Avenue de Lafayette
    Boston, MA 02111-1750

Notification that a Form 109 - Notification of Withdrawal or Complaint was received

Receipts of Form 109 - Notification of Withdrawal of Claim or Complaint are not shown on the computer. The judge's secretary will enter the withdrawal into the computer to reflect the change. If the withdrawal isn't shown in the computer, contact the judge's secretary to make sure it was removed from the judge's docket.

Notifying the DIA when your law office moves

According to Francisco Pena, Claims Manager, Office of Claims Administration, "All attorney changes should be sent by letter, to Francisco Pena, in the Claims Processing Unit. The problem with submitting Notice of Change/Appearance of Counsel - Form 114 is that some attorneys neglect to give us all information we need. In the letters they need to explain what the issues are such as: the firm is moving or changing their address; an attorney is leaving 1 firm to go to another and he/she is taking any cases with them (a Notice of Change/Appearance of Counsel Form - 114 needs to be filed on each case). Maintaining the tables of changes/updates/additions in the DIA database system are now very detailed for the attorney/law firm tables."

Out of State medical providers and Massachusetts workers' compensation medical rates

The DIA Reviewing Board has ruled, in the Tedeschi case, that out-of-state providers ARE bound by the rates set by Massachusetts. In an accepted case, providers that believe they have received less than they're entitled to should file a Third Party Claim/Third Party Notice Of Lien - Form 115.

Additional Resources for

Withdrawing from a case pending before a judge

If your client has discharged you from their case, and it's been referred to Dispute Resolution you need to contact the judge with jurisdiction over the case. If the judge with jurisdiction allows you to withdraw, you'll need to notify Omar Hernandez, Senior Judge, informing him of your withdrawal.

Filing attorney liens

If there's a dispute regarding § 13A for which a judicial proceeding is being sought, file a Form 115 - Third Party Claim/Notice of Lien and check off the CLAIM box at the top and fill out box number 14.

If you want to attach a notice of lien on the case, and no proceeding before the board is desired, you must also fill out the Form 115 - Third Party Claim/Notice of Lien and check off the LIEN box at the top of the form and fill out box number 13.

Third party settlement requests

There is no form for a third-party settlement, but there is a required format, Petition For Approval Of Third Party Settlement Under M.G.L. c. 152, Section 15 . You're encouraged to use the Section 15 Interactive Petition v.2.62  xls format of Section 15 Petition
and the Section 15 Calculator Version 8.5  xls format of Section 15 Calculator Version 8.5

Questions regarding such claims should be addressed to the Section 15 Petition Processing in Boston at (857) 321-7384

Interpreters have to be certified for certain proceedings

Interpreters don't need to be certified to interpret at Conciliations or Conferences, but certified interpreters are required to translate at formal Hearings. For more information, please see the List of Interpreters  by the Trial Court.

Certified copies of DIA files

The DIA certifies Conference Orders, Hearing/Review Board Decisions as well as memorandums of agreement (Lump Sum Agreements and Agreements to Pay Compensation - Form 113). The procedure is as follows:

1. Put the request in writing and submit it to:
Keeper of Records
Lafayette City Center
2 Avenue de Lafayette
Boston, MA 02111-1750

2. There is a certification fee of $10.00 per document. Please include payment with your written request and make check payable to the "Commonwealth of Massachusetts."

Please note that the turn around time for certified copies depends on whether or not you submit a copy of the document with your request and check (1 day) or the file has to be retrieved and the requested copy made (1 - 2 weeks) then certified.

Getting access to documents in DIA file


There is no department form for parties to use if they want to go to arbitration. You just need to submit to the Conciliation Unit a signed agreement by all parties, stating they will accept arbitration. The requirements for what must be included in the agreement, and other guidance, is contained in MGL C. 152, § 10B

If an arbitration award is made, then you would need to notify the department on a Form 124A - Notification of Arbitration Award .

Attorney Fees

Attorneys fees are governed by MGL c .152, §13A

The amounts change every October 1st.

Subpoenaeing records to the DIA

The DIA CAN'T accept subpoenaed medical records. You must make some sort of private agreement with the keeper of records of the institution you're requesting records from.