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Massachusetts Workers’ Compensation Reference Chart for Adjusters, Produced by AI

23 Aug, 2025 Frank Ferreri

                               

Coverage Requirements

All employers must carry workers' compensation insurance for employees, including part-time and seasonal workers. Sole proprietors, partners, and LLC members may opt out. Corporate officers with ≥25% ownership may file Form 153 to exempt themselves.

Claim Reporting & Filing

TriggerAction RequiredDeadline
≥5 days of disabilityEmployer files Form 101Within 7 days of 5th day of disability
Insurer receives Form 101 or ClaimFile Form 103 (Payment) or Form 104 (Denial)Within 14 days

Penalties range from $200 to $10,000 for delays.Benefit Types & Calculations

Benefit TypeSectionRateDuration
Temporary Total Disability (TTD)§3460% of AWWUp to 156 weeks
Temporary Partial Disability (TPD)§3560% of wage loss (max 75% of §34)Up to 260 weeks (or 520 weeks with extension)
Permanent & Total Disability (PTD)§34A66.67% of AWWLifetime
Scarring / Loss of Function§36Based on severity and SAWWLump sum
Medical Treatment§30All necessary careNo time limit

Medical & Vocational Services

  • Medical bills follow DIA fee schedule.
  • Utilization Review (UR) required even for denied claims.
  • Workers may choose their doctor but can only switch once per specialty without insurer approval.
  • Vocational rehab under §30G includes training and job placement.

Dispute Resolution Process

  1. Conciliation: Informal meeting.
  2. Conference: Judge issues temporary order.
  3. Hearing: Formal proceeding with evidence.
  4. Appeals: Reviewing Board and Court of Appeals.

Adjuster Responsibilities

  • Timely filing of Forms 103/104.
  • Accurate AWW calculation.
  • Monitor benefit eligibility and duration.
  • Coordinate UR and medical bill review.
  • Communicate with DIA, employer, and injured worker.
  • Avoid penalties for late actions.

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About The Author

  • Frank Ferreri

    Frank Ferreri, M.A., J.D. covers workers' compensation legal issues. He has published books, articles, and other material on multiple areas of employment, insurance, and disability law. Frank received his master's degree from the University of South Florida and juris doctor from the University of Florida Levin College of Law. Frank encourages everyone to consider helping out the Kind Souls Foundation and Kids' Chance of America.

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