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Mass workers comp affidavit 2025

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The document is a Workers’ Compensation Insurance Affidavit from the Commonwealth of Massachusetts Department of Industrial Accidents, intended for builders, contractors, electricians, and plumbers. It requires applicants to provide information about their business status, project type, and workers' compensation insurance coverage. The affidavit must be completed accurately to comply with Massachusetts General Laws chapter 152, which mandates that employers secure workers' compensation for their employees. Failure to comply may result in penalties. The document also outlines the responsibilities of city or town officials regarding the affidavit.

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Click ‘Get Form’ to open the mass workers comp affidavit in the editor.
Begin by filling in your applicant information. Clearly print your name, address, city/state/zip, and phone number in the designated fields.
Indicate your employment status by checking the appropriate box that describes your situation—whether you are a general contractor, sole proprietor, homeowner, or corporation.
Specify the type of project you are undertaking by selecting one from the list provided. This is a required field.
If applicable, provide details about your workers' compensation insurance policy including the insurance company name, policy number, and expiration date.
Attach any necessary documents such as proof of insurance and ensure all information is accurate before signing and dating the affidavit.

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Can workers comp stop paying without notice in Massachusetts?

The worker's compensation insurance company is required by law to pay you certain benefits. They are not allowed to stop paying those benefits unless you are returned to health or certain other factors are met and can workers comp stop payment without notice. It is important that you understand your rights.

How long can a workers comp claim stay open in Massachusetts?

What is the statute of limitations? Under the workers compensation law, (MGL c. 152, § 41) for injuries on or after January 1, 1986, a claim must be filed with the insurer within 4 years of the date you become aware of a connection between your injury/illness and your employment.

Is Workers Comp mandatory in MA?

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. The requirement applies no matter the number of hours worked or the number of employees.

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What is the waiting period for workers compensation in Massachusetts?

The only waiting period that exists for benefits is the five calendar days the employee must be out-of-work as a result of the job-related injury. Benefits will begin on that sixth day. However, if a person is out-of-work for longer than 21 days, the insurer will be required to pay for those first five days.

How does workers comp work in MA?

If you were injured at work, you may be eligible for workers' compensation benefits. If you qualify, you can receive payments to partially replace your paycheck and for medical care related to your injury. You may also be eligible for vocational rehabilitation if you need help getting back to work.

What is the statute of limitations for workers compensation in Massachusetts?

Who pays for workers compensation in Massachusetts?

Massachusetts Workers' Compensation Requirements Companies with one or more employees are required to buy workers' compensation insurance. Even companies who employ only family members are still required to have coverage.

Do independent contractors need workers comp in Massachusetts?

However, if you hire independent contractors, you won't have to provide them with workers' comp coverage if you can meet three tests: Prove that they do not work under your direct control or supervision. Establish that they perform work that is outside the normal course of your business.