What is Form 105 in Massachusetts?

What is Form 105 in Massachusetts?

Form 105 in Massachusetts, also known as the “Employee’s First Report of Injury,” is a crucial document that plays a significant role in the workers’ compensation process. If you sustain a work-related injury or illness in Massachusetts, filing a Form 105 is an essential step to initiate your claim. Let’s delve into what Form 105 entails and its significance.

Form 105 is used to report an injury or illness sustained by an employee while on the job. It serves as a formal notification to your employer and their workers’ compensation insurance carrier that you have suffered a work-related incident. This form captures essential details about the incident, such as the date, time, and location of the injury, as well as a description of how it occurred.

Submit Form 105 ASAP

It is crucial to complete and submit Form 105 as soon as possible after the injury or illness occurs. Massachusetts law requires employees to report work-related injuries within 30 days to be eligible for workers’ compensation benefits. Failing to file the form within the specified timeframe may jeopardize your ability to receive the benefits you are entitled to.

Once you have completed the form, it should be submitted to your employer. They are responsible for providing the necessary information, including their portion of the form, within seven days of receiving it. The employer then forwards the completed Form 105 to their workers’ compensation insurance carrier for review and further action.

After receiving the form, the insurance carrier will investigate the claim and determine whether to accept or deny it. If the claim is accepted, you may be eligible for various workers’ compensation benefits, such as medical expenses coverage, wage replacement, vocational rehabilitation, and disability benefits.

Submitting a Claim

Form 105 acts as the initial step in the workers’ compensation process, setting the foundation for your claim. It is essential to be thorough and accurate when completing the form, providing all relevant information about your injury or illness. Any discrepancies or missing details may delay the processing of your claim or even lead to a denial.

If you encounter any challenges or uncertainties when completing Form 105, consulting with an experienced workers’ compensation attorney in Massachusetts can be immensely beneficial. They can guide you through the process, ensure that your rights are protected, and help you navigate any complexities that may arise.

Form 105 is a critical document in the Massachusetts workers’ compensation system. It serves as the initial report of a work-related injury or illness and initiates the process of seeking benefits. By promptly completing and submitting this form, you are taking an essential step toward receiving the compensation and support you need to recover from a work-related incident. For more answers to questions on workers compensation in MA. Contact attorney Todd Beauregard. 978-275-1919.

(978) 275-1919