Workers’ Compensation Claim Kit – Massachusetts

Who will handle your claims?
The New Jersey Regional Claim Office will handle your Massachusetts claims, located at:

305 Madison Ave
P.O. Box 1973
Morristown, NJ 07962

Phone: (888) 890-1500
Diane Parrish, Regional Director

How to report Workers’ Compensation claims?

To report via the Internet: Log on to the Crum & Forster website at Use your assigned User ID and Password. If you do not have a current User ID, please contact your local Crum & Forster Claims or Marketing resource.

To report e-mail:
To report via fax: 1-877-622-6218
To report claims via telephone: 1-800-690-5520

(7 day/24 hour toll free reporting line for all states)

  • In the event of a serious or fatal injury, notify the local claim office immediately by telephone.

What forms and pamphlets does the employer need to be aware of?

Posting Notice:
Prominently display the notice where each employee is likely to see the notice on a regular basis. The Massachusetts posting notice is available on the Crum & Forster website.

Employer’s Guide to Workers Compensation

Mass-Employers Guide-rev 4.14

Employer’s First Report of Injury form


Employer’s Wage Statement

File this form with the carrier, claimant, and claimant’s representative when the claimant is losing time from work.

Mass-Earning Report Form 126-rev

Supplemental Report of Injury & Instructions
Massachusetts does not have a supplementary form.

Waiting Period for Lost Wages in Massachusetts
The waiting period is 5 days. If the employee is off for more than 21 days, the first 5 days are paid retroactively.

Choice of Physician Rules in Massachusetts
The employee is entitled to the initial choice of physician.

Preferred Provider Organization Network (PPO)
Crum & Forster has a PPO network available. Follow the instructions below to access the PPO Network:

Logon to the website at:

  • Search by Provider Address, Name or Region
  • Select the Distance, Provider Type and Specialty
  • Results can then be exported to a directory or excel.
  • You can obtain a Map List or text message by selecting a specific provider

Where should all medical bills be sent?

Crum & Forster
PO Box 14801
Lexington, KY 40512

Important Websites

Mass. Dept. of Industrial Accidents-

Multi-State Information-