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Form 107 Insurer's Notification of Acceptance, Resumption, Termination or Modification of Weekly Compensation - Massachusetts
What Is Form 107?
This is a legal form that was released by the Massachusetts Department of Industrial Accidents - 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 107?A: Form 107 is the Insurer's Notification of Acceptance, Resumption, Termination or Modification of Weekly Compensation form used in Massachusetts.
Q: Who uses Form 107?A: Insurers use Form 107 to notify the Massachusetts Department of Industrial Accidents about the acceptance, resumption, termination, or modification of weekly compensation.
Q: What is the purpose of Form 107?A: The purpose of Form 107 is to provide official notification to the Department of Industrial Accidents regarding changes in an injured worker's weekly compensation status.
Q: When should Form 107 be used?A: Form 107 should be used whenever there is a change in an injured worker's weekly compensation status, including acceptance, resumption, termination, or modification.
Q: Is Form 107 required by law?A: Yes, Form 107 is required by law in Massachusetts.
Q: What information is required on Form 107?A: Form 107 requires information about the injured worker, the insurer, the employer, and details about the acceptance, resumption, termination, or modification of weekly compensation.
Q: What are the consequences of not submitting Form 107?A: Failure to timely submit Form 107 may result in penalties and fines imposed by the Department of Industrial Accidents.
Q: Are there any fees associated with Form 107?A: No, there are no fees associated with filing Form 107.
Form Details:
- Released on July 1, 2019;
- The latest edition provided by the Massachusetts Department of Industrial Accidents;
- 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 107 by clicking the link below or browse more documents and templates provided by the Massachusetts Department of Industrial Accidents.
Download Form 107 Insurer's Notification of Acceptance, Resumption, Termination or Modification of Weekly Compensation - Massachusetts
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