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Massachusetts Forms

72 State Forms found

name	number	revision	print or send online
AGREEMENT TO PAY COMPENSATION	Form 113	Revised 7/2019
AGREEMENT UNDER SECTION 37 or 37A	Form 123	Revised 7/2024
AMENDMENT, SUSPENSION, OR CLOSURE OF VOCATIONAL REHABILITATION	OEVR Form #152	Revised 8/2022
APPEAL OF CONFERENCE PROCEEDING	Form 121	Revised 7/2019
APPEAL TO REVIEWING BOARD	Form 112	Revised 7/2019
UTILIZATION REVIEW APPLICATION	452CMR 6.00	Revised July 2019
AVERAGE WEEKLY WAGE COMPUTATION SCHEDULE	Form 127	Revised 7/2019
COMPLAINT OF IMPROPER CLAIMS HANDLING AGAINST AN INSURER	Form 130	Revised 7/2019
EMPLOYEE’S EARNING REPORT	Form 126	Revised 7/2019
EMPLOYEE’S HEARING MEMORANDUM	Form 161	Revised 12/2023
CONSENT OF EMPLOYER TO LUMP SUM SETTLEMENT	Form 116A	Revised 7/2019
HEALTH CARE PROVIDER COMPLAINT FORM	Form 134	Revised 7/2019
INDIVIDUAL WRITTEN REHABILITATION PROGRAM	Form 151	Revised 7/2019
INSURANCE INQUIRY FORM	No Form Number	Revised 04/22/2025
INSURER’S COMPLAINT FOR MODIFICATION, DISCONTINUANCE OR RECOUPMENT OF COMPENSATION	Form 108	Revised 7/2019

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Disclaimer: These forms may not be the most recent version. Massachusetts may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on this site. Please check official sources.

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