| Product |
SKU |
More Info
|
| Massachusetts Addendum To Lump Sum Agreement. Vocational Rehabilitation Status (Form 116B) |
FFMA075 |
 |
| Massachusetts Affidavit In Support Of Employee's Request For Speedy Conference Because Of Hardship |
FFMA085 |
|
| Massachusetts Affidavit In Support Of Request For Waiver Of Filing Fee Under Section 11C (Form 112A) |
FFMA090 |
|
| Massachusetts Affidavit of Employee in Application for Trust Fund Benefits (Form 170) |
FFMA095 |
|
| Massachusetts Affidavit of Exemption for Certain Corporate Officers (Form 153) |
FFMA100 |
|
| Massachusetts Affidavit of Indigence and Request for Waiver of Section 11A (2) Fees (Form 136) |
FFMA105 |
|
| Massachusetts Affidavits for Builders, Contractors, Plumbers, and Electricians |
FFMA120 |
|
| Massachusetts Affidavits for General Businesses |
FFMA125 |
|
| Massachusetts Agreement for Redeeming Liability by Lump Sum - for injuries before Nov. 1, 1986 (Form |
FFMA130 |
|
| Massachusetts Agreement for Redeeming Liability by Lump Sum - for injuries on or after Nov. 1, 1986 |
FFMA135 |
|
| Massachusetts Agreement that no Impartial Physician Report is Required (Form 121A) |
FFMA140 |
|
| Massachusetts Agreement To Extend 180 Day Payment-Without-Prejudice Period (Form 105) |
FFMA145 |
|
| Massachusetts Agreement To Pay Compensation (Form 113) |
FFMA150 |
|
| Massachusetts Amendment, Suspension or Closure of Vocational Rehabilitation Plan (Form 152) |
FFMA155 |
|
| Massachusetts Appeal Of Conference Order (Form 121) |
FFMA160 |
|
| Massachusetts Appeal To Reviewing Board (Form 112) |
FFMA165 |
|
| Massachusetts Application For Approval Of Utilization Review And Quality Assessment Program |
FFMA170 |
|
| Massachusetts Application To Serve As An Impartial Physician |
FFMA175 |
|
| Massachusetts Average Weekly Wage Computation Schedule (Form 127) |
FFMA180 |
|
| Massachusetts Chart - 125 Percent of Poverty Guidelines |
FFMA115 |
|
| Massachusetts Complaint of Improper Claims Handling Against an Insurer (Form 130) |
FFMA185 |
|
| Massachusetts DOR Lien Release Request Guidance |
FFMA190 |
|
| Massachusetts Employee Biographical Data form (Form 160) |
FFMA195 |
|
| Massachusetts Employee Claim Form -- With Instructions (Form 110) |
FFMA200 |
|
| Massachusetts Employee Earning Report (Form 126) |
FFMA205 |
|
| Massachusetts Employee's Hearing Memorandum - Form Revised - August 5, 2004 (Form 161) |
FFMA210 |
|
| Massachusetts Employer Consent To Lump Sum Agreement (Form 116A) |
FFMA215 |
|
| Massachusetts Employer First Report of Injury -- With Instructions (Form 101) |
FFMA220 |
|
| Massachusetts Employer's Guide to Workers Compensation - Cape Verdean |
FFMA045 |
|
| Massachusetts Employer's Guide to Workers Compensation - Chinese |
FFMA050 |
|
| Massachusetts Employer's Guide to Workers Compensation - English |
FFMA040 |
|
| Massachusetts Employer's Guide to Workers Compensation - Haitian Creole |
FFMA055 |
|
| Massachusetts Employer's Guide to Workers Compensation - Portuguese |
FFMA060 |
|
| Massachusetts Employer's Guide to Workers Compensation - Spanish |
FFMA065 |
|
| Massachusetts Employer's Guide to Workers Compensation - Vietnamese |
FFMA070 |
|
| Massachusetts Health Care Provider Complaint Form (Form 134) |
FFMA225 |
|
| Massachusetts Individual Written Rehabilitation Program Form (Form 151) |
FFMA230 |
|
| Massachusetts Injured Worker's Guide to Workers Compensation - Cape Verdean |
FFMA010 |
|
| Massachusetts Injured Worker's Guide to Workers Compensation - Chinese |
FFMA015 |
|
| Massachusetts Injured Worker's Guide to Workers Compensation - English |
FFMA005 |
|
| Massachusetts Injured Worker's Guide to Workers Compensation - Haitian Creole |
FFMA020 |
|
| Massachusetts Injured Worker's Guide to Workers Compensation - Portuguese |
FFMA025 |
|
| Massachusetts Injured Worker's Guide to Workers Compensation - Spanish |
FFMA030 |
|
| Massachusetts Injured Worker's Guide to Workers Compensation - Vietnamese |
FFMA035 |
|
| Massachusetts Insurance Certification Request Form |
FFMA235 |
|
| Massachusetts Insurance Coverage Posting for Employers |
FFMA240 |
|
| Massachusetts Insurance Inquiry Form |
FFMA245 |
|
| Massachusetts Insurer's Complaint For Modification, Discontinuance Or Recoupment Of Compensation (Fo |
FFMA250 |
|
| Massachusetts Insurer's Hearing Memorandum (Form 162) |
FFMA255 |
|
| Massachusetts Insurer's Notification Of Acceptance, Resumption, Termination Or Modification Of Weekl |
FFMA260 |
|
| Massachusetts Insurer's Notification Of Denial (Form 104) |
FFMA265 |
|
| Massachusetts Insurer's Notification Of Payment (Form 103) |
FFMA270 |
|
| Massachusetts Insurer's Notification Of Termination or Modification Of Weekly Compensation During Pa |
FFMA275 |
|
| Massachusetts Last Best Offer at Conference (Form141) |
FFMA280 |
|
| Massachusetts Lien Disclosure Form (Form 116C) |
FFMA285 |
|
| Massachusetts Motion For Expedited Conference New Form February 2007 (Form 125) |
FFMA295 |
|
| Massachusetts Notice Of Change/Appearance of Counsel (Form 114) |
FFMA300 |
|
| Massachusetts Notification Of Arbitration Award (Form 124A) |
FFMA305 |
|
| Massachusetts Notification Of Withdrawal Of Claim Or Complaint (Form 109) |
FFMA310 |
|
| Massachusetts Petition For Approval Of Third Party Settlement Under M.G.L. c. 152, Section 15 |
FFMA315 |
|
| Massachusetts Request For Lump Sum Conference (Form 116) |
FFMA330 |
|
| Massachusetts Request For Section 37/37A Proceedings/Agreement Forms (Forms 122 and 123) |
FFMA320 |
|
| Massachusetts Request For Section 46a Conference in Conjunction With Lump Sum Under Section 48 (Form |
FFMA325 |
|
| Massachusetts Request For Speedy Conference Because of Hardship |
FFMA080 |
|
| Massachusetts Request to Keeper of Records for file information |
FFMA335 |
|
| Massachusetts Section 15 Calculator Version 8.0 |
FFMA345 |
|
| Massachusetts Section 15 Interactive Petition |
FFMA340 |
|
| Massachusetts Section 50 Interest Calculator |
FFMA350 |
|
| Massachusetts Standards And Procedures For § 11A(2) Fee Waiver Requests |
FFMA110 |
|
| Massachusetts Temporary Conference Memorandum Cover Sheet (Form 140) |
FFMA355 |
|
| Massachusetts Third Party Claim/Notice Of Lien (Form 115) |
FFMA360 |
|
| Massachusetts Utilization Review (UR) Agent Complaint Form (Form 133A) |
FFMA365 |
|
| Massachusetts Workers' Compensation COLA Data Form (CR-28) |
FFMA290 |
|
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