- Addendum To Lump Sum Settlement Agreement {116B}
- Affidavit (Builders-Contractors-Electricians-Plumbers)
- Affidavit (General Business)
- Affidavit In Support Of Employees Request For Speedy Conference Because Of Hardship {132}
- Affidavit In Support Of Request For Waiver In Filing Fee Under s11C {112A}
- Affidavit Of Employee In Application For Trust Fund Benefits {170}
- Affidavit Of Exemption For Certain Corporate Officers Or Directors {153}
- Affidavit Of Indigence And Request For Waiver Of Section 11A(2) Fees {136}
- Agreement For Redeeming Liability By Lump Sum - For Injuries Before 11-1-86 {117A}
- Agreement That No Impartial Physician Report Is Required {121A}
- Agreement To Extend 180 Day Payment Without Prejudice Period {105}
- Agreement To Pay Compensation {113}
- Agreement Under Section 37 Or 37A {123}
- Amendment-Suspension-Closure Of Vocational Rehabilitation Plan {152}
- Appeal Of Conference Proceeding {121}
- Appeal To Reviewing Board {112}
- Application For Employment Agency License Or Placement Agency Registration
- Average Weekly Wage Computation Schedule {127}
- Certified Vendor Quarterly Report For OEVR
- Complaint Of Improper Claims Handling Against Insurer {130}
- Conference Memorandum Cover Sheet {140}
- Consent Of Employer To Lump Sum Settlement {116A}
- DIA File Request (Request To Keeper Of Records For File Information)
- Employee Biographical Data {160}
- Employees Claim For Post-Lump Sum Medical Mediation {110A}
- Employees Earning Report {126}
- Employees Hearing Memorandum {161}
- Exemption Certificate Form M-4
- Form 117 Lump Sum Settlement Agreement For Injuries On or After 11-1-1986 {117}
- Form 19A Section 19A Medical Mediation Agreement {19A}
- Health Care Provider Complaint Form {134}
- Individual Written Rehabilitation Program {151}
- Insurance Inquiry Form
- Insurer Request Certification
- Insurers Hearing Memorandum {162}
- Joint-Pre-Hearing-Memorandum
- Last Best Offer At Conference {141}
- Lien Disclosure Form {116C}
- MGL Sec. 65B Appeal Of Cancellation Or Termination Of Policy
- Mileage Voucher
- Motion For Expedited Conference {125}
- New Hire Reporting
- Notice To Employees (Of Workers Compensation Coverage)
- Notification Of Arbitration Award {124A}
- Notification Of Withdrawal Of Claim Or Complaint {109}
- OEVR Referral (For All Parties For Mandatory Meetings)
- Request For Section 37 Or 37A Proceeding {122}
- Request For Section 46a Conference With Lump Sum Under Section 48 {46A}
- Request For Speedy Conference Because Of Hardship {131}
- Section 19 Agreement {19}
- Statement Of Eligibility To Serve On Roster Of Impartial Physicians {A-1}
- Uniform Lump Sum Settlement Employee Affidavit
- Utilization Review Agent Complaint Form {133A}
- Utilization Review Application (To Become An Approved Agent And Affidavit Of Compliance)
- Verification Of Massachusetts Workers Compensation Coverage For Out-Of-State Employers {154}
- Workers' Compensation COLA Data Form {CR-28}
- Workers Compensation Insurance Affidavit - Building Plumbing Electrical Contractors
- Workers Compensation Insurance Affidavit - General Businesses