WebYou may be asked for a Board Number when entering information. The DIA Board Number is the number we, the DIA, assign our cases. If you don't know the DIA Board Number, … WebThe first day on which the claimant originally lost time from work due to the occupation injury or disease or as otherwise designated by statute. CONTACT NAME/PHONE NUMBER: Enter the name of the individual at the employer’s premises to be contacted for additional information. TYPE OF INJURY/ILLNESS:

Workers

WebThe Employer’s First Report Of Injury/Fatality Form 101 (First Report of Injury). This form must be filed electronically with the Department of Industrial Accidents (DIA) within seven calendar days (not including … WebMar 15, 2024 · This state-by-state guide is a quick reference for workers’ compensation deadlines after an injury from an accident or onset of an occupational disease. For the most accurate, up-to-date information, you should contact your state workers’ comp officials. Get Workers’ Comp Coverage for Your State great job greeting cards

Workplace Injuries & Illnesses Mass.gov

WebPENALTIES: Failure to report injuries on this form may result in a fine of $100.00 in accordance with M.G.L. Chapter 152, Section 6. 4. EMPLOYER’S NAME & SIGNATURE IN BOXES 37 & 39: This form must be filed by the employer or an authorized agent/representative of the WebJan 29, 2016 · About. A Cape Cod Chiropractor with over 18 years of experience, Dr. Joshua Lindauer, BS, DC holds a bachelor's degree in Applied Human Anatomy (SUNY Auburn). He graduated cum laude from New York ... WebReport an Injury for Massachusetts Print this page EMPLOYER'S FIRST REPORT OF INJURY *Internet Explorer is not recommended for First Report of Injury submissions* … floating point binary questions and answers