Obtaining Workers’ Compensation Coverage


By KJC Law Firm

All employees in Massachusetts must carry workers’ compensation insurance for all employees and themselves if they are a member of the company. The requirement applies to everyone no matter how many hours worked or the number of employees. The only exception is for domestic employees who must work at least 16 hours a week to be eligible for workers’ comp insurance.

Members of limited liability companies (LLC), partners of a limited liability partnership (LLP), or sole proprietors of an unincorporated business do not have to carry workers’ comp insurance for themselves. This exemption does not include employees who are not members of the LLC or LLP. They must be covered. If these exception cases want coverage, they should contact an insurance broker.

Massachusetts employees do not have to opt out of coverage. Instead, corporate officers or directors that owe at least 25 percent interest in the corporation may opt out of coverage for themselves by filing an Affidavit of Exemption for Certain Corporate Officers or Directors.

To obtain workers’ compensation coverage, private employers are allowed to purchase insurance from a workers’ compensation carrier through:

  • Standard commercial coverage and target programs
  • A risk pool governed by Workers’ Compensation Rating and Inspection of Bureau of Massachusetts
  • Individually self-insure
  • Provide coverage through membership in self-insured groups.

What you need

To file a workers’ compensation claim with the Department of Industrial Accidents (DIA) you will need:

  • The date of illness, injury, or death if a dependent is filing for workers’ comp benefits
  • The 1st calendar day of work you missed
  • The 5th calendar day of work you missed
  • The body parts and types of injuries
  • The workers’ compensation insurance carrier
  • How long you may be out of work, if known
  • The type of benefits you are looking for
  • The location of your treatment center
  • Your current doctor giving treatment

In addition, you are required to attach at least one of the following items below to the Form 110- Employee Claim and bring the rest with you to the conciliation which is the first step in the process.

  • Unpaid medical bills
  • Medical reports
  • Any reports that support how the accident occurred
  • Witness names
  • Witness statements

You can see if your employer has workers’ compensation insurance online.

How to File

By Mail

In order to file a claim, download and complete Form 110-Employee Claim. You will need to have 3 copies of this form and the following materials:

  • 1 copy for the DIA
  • 1 copy for the workers’ compensation carrier
  • 1 copy for your records, or in case you hire an attorney at a later date

Send your original copy of Form 110- Employee Claim in addition to the copies of supporting documents to:

Department of Industrial Accidents
Dept. 110
Lafayette City Center
2 Avenue de Lafayette
Boston, MA 02111-1750

In person

Submit the signed copy of Form 110- Employee Claim with copies of the supporting documents at the DIA office:

Department of Industrial Accidents
Dept. 110
Lafayette City Center
2 Avenue de Lafayette
Boston, MA 02111-1750

Following Steps

Get Notification

Once you have completed the form and have attachments, you will need to make 3 copies.

  • Send a copy of the Form 110- Employee Claim and all other documents to your employer’s workers’ compensation carrier through Certified Mail.
  • You much attach copies of any medical reports, bills, etc. to the form you send to the insurer even if you know that they already have them. If the documents are not attached, the insurer’s attorney will ask the DIA to stop the claim because it was not filed correctly.

The DIA will review and respond to your claim in the following ways:

  • The DIA can reject the form and send everything back to you for several reasons. A rejection letter is attached to the form stating what information is missing or incorrect.
  • If the information is correct, the DIA will send a notice to you, your employer, and your insurance company with the date, time, and place to meet a conciliator to talk about the claim. This meeting is informal and called a conciliation.
    • The employer will get a notice as a courtesy. The employers do not need to appear unless the insurance company wants them to, or if they had no workers’ comp on the date of illness or injury.


Most of the time, claims get rejected by the DIA because they have the incorrect insurance carrier, do not enter the 1st or 5th day of disability, or have not checked off the different types of benefits they are looking for. You can look at any of the insurer forms they send you to see the name of your employer’s insurance company. You can also see this form on Form 104- Notification of Denial. You can call the Office of Insurance for assistance or look up the insurer your employer has online.

If your employer does not hold any workers’ comp insurance, you will need to make a claim against the Workers’ Compensation Trust Fund, which is part of the DIA.

For more information, check out our blog!

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