We help business owners navigate Massachusetts workers' comp rules.

Workers' Compensation Shop.com offers free access to Massachusetts workers' compensation forms, applications, and guides. We make every effort to keep our forms library up to date with the latest document versions so check back soon.

If you have questions about a workers' comp form or you need help locating a form, please contact a Specialist at 888-611-7467.

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Massachusetts Workers' Comp Insurance Forms

Massachusetts Acord 130 Workers' Compensation Application

The standard Acord 130 application form for workers' comp coverage in Massachusetts.

Understanding Workers' Compensation in Massachusetts Brochure

Employee brochure about Massachusetts workers' compensation insurance with helpful contact numbers for state and regional offices.

Massachusetts First Report of Injury Form

First Report of Injury Form.  Employers should complete this form and send to their insurance company each time an injury occurs.

Massachusetts Employers Guide to Workers' Compensation

An Employers Guide to Massachusetts Workers' Compensation published by the MA Department of Industrial Accidents.

Massachusetts Workers' Compensation Notice to Employees

The Massachusetts Department of Insurance requires all employers to post this Notice to Massachusetts Employees in the workplace.

Massachusetts Workers' Compensation Claim Form

Complete this form to file an official workers' compensation claim with the Massachusetts Department of Labor and Workforce Development.

Massachusetts Application for Exclusion of Officers and Stockholders

Owners and Officers of corporations should complete this form to exclude themselves from a work comp policy.

Massachusetts Application for Exemption for Workers' Compensation Insurance

Complete this form if you are a sole-proprietor, partnership with no employees or an sole officer of a corporation and would like to be exempt from coverage.

Facts for Injured Workers In Massachusetts

Information about workers' compensation in Massachusetts for workers and employers.

Workers' Comp Exemption

Each state has its own laws and requirements regarding when and how employers are allowed to opt-out of coverage under their workers' compensation policy. Some states make it easier than others because they don't require anything to be filed. Other states require special inclusion or exclusion affidavit documentation. Failure to comply often causes employers to have to pay premium on themselves even when they wanted to be excluded form coverage.

Waiver of Subrogation

A waiver of subrogation means that a business and their insurance company is foregoing all rights to file suit, or seek damages, from another business. This is common in the construction industry as builders attempt to protect their company from negligence. A workers' comp waiver of subrogation does not prevent an injured employee from filing a lawsuit for damages. This coverage typically add about $100 to the cost of a work comp policy.

Certificate of Insurance

A Certificate of Insurance is a document that serves as evidence of insurance or proof of coverage. Certificates indicate your current coverages and policy limits. Insurance Agencies issue on an insured's behalf and they often list a third party as a certificate holder. This means they should be notified if a policy cancels prior to expiration. Requests for any special wording should be carefully checked against the policy language before being added to a certificate as they can create legal issues with coverage.


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State Resources for Massachusetts

Massachusetts Division Of Insurance

One South Station, 5th Floor
Boston, MO 02110-2208
617-521-7794
Consumer Affairs and Business Regulation

Workers' Compensation Rating and Inspection Bureau

101 Arch Street
Boston, MA 02110
617-439-9030
Workers' Compensation Rating and Inspection Bureau of Massachusetts

Workers' compensation insurance in Massachusetts pays for medical bills, prescriptions, related travel costs, and lost wages for employees who are unable to work for 5 or more days because of a work-related injury.

Massachusetts forms and applications such as officer exclusion forms are sometimes updated by the state. Contact us if you need help or can't find the workers' compensation form you need for Massachusetts.

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We've developed Target Programs with key insurance companies that provide bigger discounts and more credits.

Visit NCCI for more resources and information about workers' compensation class codes. Visit United States Department of Labor for more information about government agencies managing workers compensation insurance rates.

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