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This version of the form is not currently in use and is provided for reference only. Download this version of
Form 117
for the current year.
Form 117 Agreement for Redeeming Liability by Lump Sum Under G.l. Ch. 152 for Injuries Occurring on or After Nov. 1, 1986 - Massachusetts
What Is Form 117?
This is a legal form that was released by the Massachusetts Department of Fire Services - a government authority operating within Massachusetts. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form 117 Agreement?A: Form 117 Agreement is a document used for redeeming liability by lump sum under G.l. Ch. 152 for injuries occurring on or after Nov. 1, 1986 in Massachusetts.
Q: What is the purpose of Form 117 Agreement?A: The purpose of Form 117 Agreement is to settle workers' compensation claims by providing a lump sum payment instead of ongoing benefits.
Q: Who is eligible to use Form 117 Agreement?A: Both the injured worker and the employer/insurer can use Form 117 Agreement to reach a lump sum settlement.
Q: When can Form 117 Agreement be used?A: Form 117 Agreement can be used for injuries occurring on or after Nov. 1, 1986 in Massachusetts.
Q: What is G.l. Ch. 152?A: G.l. Ch. 152 is a Massachusetts statute that governs workers' compensation laws and benefits.
Q: What are the benefits of using Form 117 Agreement?A: Using Form 117 Agreement allows for a lump sum payment, which can provide financial certainty and flexibility to both the injured worker and the employer/insurer.
Q: Are there any limitations to using Form 117 Agreement?A: Yes, there are limitations such as the injured worker must have reached maximum medical improvement and the lump sum settlement must be voluntary and in the best interests of both parties.
Form Details:
- Released on January 1, 2018;
- The latest edition provided by the Massachusetts Department of Fire Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form 117 by clicking the link below or browse more documents and templates provided by the Massachusetts Department of Fire Services.
Download Form 117 Agreement for Redeeming Liability by Lump Sum Under G.l. Ch. 152 for Injuries Occurring on or After Nov. 1, 1986 - Massachusetts
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