Downloadable Forms

Notice of Injury Packet Forms

Notice of Injury and Internal Claims Investigation

Medical Release

Physicians Report

Injured Workers' Guide to Medical Treatment

Concurrent Employment Review

Average Weekly Wage Computation Schedule(Form 127)

First Fill Form

Additional Forms

Notice of Resumption

Agreement to Pay Compensation (Form 113)

Insurer's Notification of Termination or Modification During Payment without Prejudice Period (Form 106)

Insurer's Notification of Acceptance, Resumption or Termination or Modification (Form 107)

Travel Reimbursement

Related Links

Massachusetts Fee Schedule

Mass Finance/VendorWeb a common access point for Commonwealth vendors from which they may get their payment information

Department of Industrial Accidents Attorney information and links to the law