Massachusetts Worker Compensation Claim

A § 65 claim is an Employee claim that allows Employees to recover Workers’ Compensation Insurance from the Commonwealth of Massachusetts if an Employee is injured in the course of their employment and their Employer does not have Workers’ Compensation Insurance or it is cancelled or unavailable to the Employee.

Pursuant to Massachusetts General Laws Ch. 152, § 65(2)(e), the Workers’ Compensation Trust Fund (WCTF) may be liable for payment of benefits resulting from approved claims against… "employers subject to the personal jurisdiction of the Commonwealth who are uninsured in violation of this chapter."

The WCTF is obligated to pay benefits to Employees of uninsured Employers who have suffered a compensable injury. An Employee of any uninsured Employer shall be entitled, without election and through the WCTF, to the weekly compensation and other medical and vocational rehabilitation benefits provided under M.G.L. c. 152. The claimant may also proceed to enforce the liability of an uninsured Employer under M.G.L. c. 152, §§ 66 and 67. The WCTF shall not be liable for any settlement or judgment in a personal injury action brought under M.G.L. c. 152, §§ 66 and 67.

Do you qualify for M.G.L.c. 152 §65 Workers’ Compensation Insurance Benefits?

Were you injured in the scope of your employment? Do you have knowledge that your Employer does not have Workers’ Compensation Insurance or that it is unavailable to you?If you answered yes, you may be entitled to Workers’ Compensation Insurance Benefits for your injury from the Commonwealth of Massachusetts, Workers’ Compensation Trust Fund.

The Employee must show that the Employer was uninsured in order to maintain a claim against the WCTF. The Employee must obtain a Certificate of No Insurance form from Michael Owen at the DIA Office of Insurance. Michael Owen has access to the electronic database maintained by the Workers' Compensation Rating and Inspection Bureau (WCRIB). WCRIB is the verification entity for Workers’ Compensation Insurance for the Commonwealth of Massachusetts.

Every Massachusetts insurance company must notify WCRIB of the issuance or termination of a Workers’ Compensation Insurance policy. The Rating Bureau will not have any information on self insurers, or insurers which are not MA insurers.

Secondly, under M.G.L. c.152 § 65(2)(e)(i) a claim may not be maintained against the WCTF if there is workers' compensation available in another jurisdiction.

When do I file a M.G.L. c. 152 § 65 claim?

The ONLY reason for filing a claim is to request a judicial proceeding before an Administrative Judge, in order to obtain workers' compensation benefits. The Workers’ Compensation Trust Fund is the named “insurer” if your employer was breaking the law by not having insurance.

There are a few steps you need to take in order to successfully file a M.G.L. c. 152 § 65 claim. The Employee Claim form should be completed to claim Workers’ Compensation benefits against the WCTF. The WCTF may contest your right to receive compensation benefits or may pay you less Workers’ Compensation benefits you believe you are entitled to.

Documentation, as required by 452 CMR 1.07, must also be attached to the Employee Claim form. This documentation needs to be sent directly to the Department of Industrial Accidents (DIA) and the WCTF.

If the claim is just for medical bills, you need to send copies of the bills/records to the DIA and the WCTF.