that they were stopping or reducing your benefits.
There are documents that need to be attached to the claim form. A list of the required documents is contained on our web site, along with other information about filing a claim with us. If you cannot get access to a computer, you can get help from our Information Office, or at a law library. At minimum, you need to attach any and all evidence that supports your claim, including medical bills, medical reports that document your injury and that it is related to your work injury or illness.
Once you complete the claim form, attach the required documents, then submit the claim package to the DIA, 600 Washington St., 7th Floor, Boston, MA 02111 (the address is printed on the top of the form). Do not submit claim forms to a regional office! All claim forms must be submitted to the Boston Office.
You must also send a copy to the insurer. By law your employer must provide you with the name and address of the insurer. If your employer refuses to provide this information, or they do not have workers' compensation insurance, notify the DIA at once. We recommend that you keep a copy of the Form 110 for your own files. When you come to any DIA office for a proceeding, be sure to bring with you any letters the insurer or the DIA has sent you, along with any other relevant paperwork, especially the notice telling you of the proceeding.
Conciliation
When you file an Employees' Claim form with the DIA, or the insurance company requests permission to stop or change your benefits, an informal meeting will be scheduled between you, the insurer, and a conciliator from this department. This meeting, called a Conciliation, normally takes place within 12 business days of our processing your claim form. At this informal meeting we will attempt to reach a voluntary agreement between you and the insurer. No decision can be ordered at this proceeding. If a voluntary agreement cannot be reached, the status of your claim would remain the same as before, and your case could be referred to one of our judges for a Conference. You and the insurer could also agree to voluntary arbitration.
Voluntary arbitration
Any time prior to five days before a Conference you and the insurer can agree to refer your disputed case to an independent arbitrator. No further action is taken by our department on your claim. You would present your case to the arbitrator, the insurance company does the same, and the arbitrator will then issue a decision that is binding on both parties.
Conference
The Conference is an informal proceeding before an administrative judge. The judge learns about the case from presentations by both parties and the submission of documents, such as medical reports, wage statements and affidavits from witnesses. Witnesses are not called; you just tell the judge what the witnesses would have said. Testimony is not sworn. At the Conference you would need to show that you were disabled, the incapacity was work-related, and that any disputed medical bills were for necessary treatment. After the Conference the judge issues an order, either telling the insurer to pay your benefits, or ruling that they are not liable for payments to you.
The Conference Order can be appealed by either party. This appeal must be filed with this department within 14 days of the issuance of the order. There is a $450 fee to appeal the Conference Order, if your appeal is based on a medical issue. This fee may be waived, if you can prove you cannot afford to pay the fee. If either party appeals the Conference Order, a formal Hearing before the same judge will be scheduled.