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Massachusetts workers compensation 2026

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Form 116A is a consent document from the Commonwealth of Massachusetts Department of Industrial Accidents, allowing an employer to agree to a lump sum settlement for workers' compensation. It includes details such as the employer's information, the settlement amount, and references relevant legal provisions.

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Click ‘Get Form’ to open the Massachusetts Workers Compensation Form 116A in the editor.
Begin by entering the DIA Board Number if known. This helps in identifying your case within the system.
Fill in your name as the sole proprietor, partner, or corporate officer in the designated field.
Provide your business name and address, ensuring all details are accurate for proper identification.
Indicate your city and state of operation, along with the name of your workers' compensation insurance carrier.
Enter the gross amount of the lump sum settlement you are consenting to receive.
Specify the case related to this settlement clearly for reference.
Review and sign the form, including the date of signing to validate your consent.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What are the three main requirements to obtain workers compensation?

All employers operating in Massachusetts are required to carry workers compensation insurance for their employees and themselves if they are an employee of their company.

How does workers comp work in Massachusetts?

You must be an employee. Your employer must carry workers comp insurance. You must have a work-related injury or illness.

What are the three main components used to calculate workers compensation premiums?

Your workers compensation premium is determined by a formula that has three primary elements: 1) the type of business you have, 2) your businesss history of workplace accidents, and 3) the total payroll of your business.

What is needed for workers compensation?

Comprehensive medical documentation is the cornerstone of any workers compensation claim. This includes medical reports, doctors notes, hospital records, and diagnostic test results related to the injury or illness.

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