Workers' comp claim denied in Massachusetts: what to do next

If the insurer denies your claim, you can call the DIA Public Information Office (free) with questions, then file an Employee's Claim with the DIA, with at least one supporting document such as a medical report, and send a copy to the insurer.

Your employer's insurer, not the state, usually decides first. If they deny or delay, the free help listed here can explain your options.

Checked against official sources: October 31, 2026.

Deadlines are strict. If you are near one, call the state agency or free help today.

If your claim is denied or delayed in Massachusetts

Who decides

Department of Industrial Accidents: conciliators, administrative judges, and the Reviewing Board

First step

If the insurer denies your claim, you can call the DIA Public Information Office (free) with questions, then file an Employee's Claim with the DIA, with at least one supporting document such as a medical report, and send a copy to the insurer. A conciliation meeting is usually scheduled about 14 days after the DIA receives it.

Source: Form 104; Form 110

Form
Employee's Claim (Form 110)
Deadline

The claim must be filed within 4 years from when you first became aware your disability was work-related. After a conference order you have 14 days to appeal, and after a hearing decision 30 days to appeal to the Reviewing Board.

Medical disagreements

After the first 12 weeks, insurers must use utilization review for medical treatment. If you appeal a conference order on a medical issue, you are examined by an impartial medical examiner chosen by the DIA; there is a fee, which can be waived if you cannot afford it.

Source: Form 136

Appealing the decision

Reviewing Board of the DIA (within 30 days of the hearing decision, errors of law only), then the Massachusetts Appeals Court (within 30 days).

  1. Conciliation: a DIA conciliator tries to help you and the insurer reach a voluntary agreement.
  2. Conference: an informal proceeding before an administrative judge, usually 8 to 12 weeks after conciliation, based on documents; the judge issues a conference order.
  3. Either side can appeal the conference order within 14 days; this leads to a formal hearing, usually before the same judge, with sworn testimony. Voluntary mediation with a different judge may be offered first.
  4. The hearing decision can be appealed to the Reviewing Board within 30 days, only for errors of law; there is a fee that can be waived.
  5. A Reviewing Board decision can be appealed to the Massachusetts Appeals Court within 30 days.

Law: M.G.L. c. 152, §§ 10, 10A, 11, 11A, 11C, 12

Source: mass.gov

Sources

The official sources for Massachusetts are listed on the Massachusetts page.