LOCAL RULES

Massachusetts incident report requirements

Your Massachusetts incident report has 4 rules to meet. ReportDraft puts every one on your checklist and checks your draft before you sign.

  • Form 101 to the DIA, the employee and the insurer once disability reaches 5 days
  • 5 full or partial days, not necessarily in a row; medical only claims go to the insurer
  • Every OSHA 301 item, completed within 7 calendar days for a recordable case
Start free: draft your Massachusetts report

ReportDraft Safety from $12 a month. 14-day free trial with your first report and up to 5 template downloads. Card required, nothing charged today, cancel anytime. Need just one? One incident report for $19, no subscription.

Massachusetts employers follow federal OSHA recordkeeping and add the workers' compensation first report (M.G.L. c. 152, s. 6): once an injury disables an employee for five or more days, the Form 101 goes to the Department of Industrial Accidents, the employee and the insurer within seven days, not counting Sundays and holidays. Here is each Massachusetts rule with a link to the General Laws and the DIA, and what a Massachusetts incident report should record.

Last reviewed October 15, 2026 against the official sources listed below.

Incident reportMASSACHUSETTS / SAMPLE

Sample notes, 140 words

Company: Northgate Fabrication
Site: 1840 Industrial Pkwy, shipping dock 2
Date: 10/08/2026, about 2:15pm
Injured: Luis Romero, material handler, warehouse crew
Supervisor: Tom Reilly
...
FREE PREVIEW OF THESE NOTES
58%of your draft is ready from these notes

We sorted 5 items into 4 sections and flagged 1 to fix first.

4 Massachusetts rules on your checklist, including Form 101 to the DIA, the employee and the insurer once disability reaches 5 days.

Still to add

  • NeededType of incident
  • NeededCompleted by
  • RecommendedNotes for damage to property, equipment or the environment

Filled in for you

Company or organizationNorthgate Fabrication
Site address or location1840 Industrial Pkwy, shipping dock 2
Date of the incidentOct 8, 2026
Employee or person involved (full name)Luis Romero, material handler, warehouse crew
Start free and draft yours

14 days free, nothing to pay today. After your first report, your name, license and company details fill in by themselves. Or preview your own notes first, no sign-up.

What Massachusetts requires

  • When an injury incapacitates an employee from earning full wages for five or more calendar days, the employer furnishes notice of the injury on the Division's form to the Department of Industrial Accidents, the employee and the insurer within seven calendar days, not counting Sundays and legal holidays; the notice gives the employer's name and business, the employee's name, age, sex and occupation, and the date, nature, circumstances and cause of the injuryM.G.L. c. 152, s. 6
  • The DIA counts five full or partial calendar days of disability, which need not be consecutive, and expects the Form 101 within seven calendar days (Sundays and legal holidays excepted) after the fifth day; shorter disabilities are medical only claims reported to the insurer, not the DIADIA, When a work-related injury needs to be reported
  • The DIA accepts Form 101 only online, through a DIA account; the filing names the insurer, the injured worker, the date and place of injury, the types of injury and the body parts, and returns a DIA transmittal number to keepDIA, File a Form 101 online
  • Anyone who violates the reporting section three or more times in a year is fined 100 dollars for each violation, and each fine not paid within thirty days of the bill is a separate violationM.G.L. c. 152, s. 6
  • Employers, insurers and medical providers may be required to file additional reports on the injury and the employee's condition, including medical, hospital and rehabilitation records and compensation paymentsM.G.L. c. 152, s. 6
  • A compensation claim cannot proceed unless notice was given to the insurer or employer as soon as practicable after the injury, and the claim is filed within four years of the employee learning the disability is work-relatedM.G.L. c. 152, s. 41

The Form 101

When an injury keeps an employee from earning full wages for five or more calendar days, send the Form 101 to the DIA, the employee and your insurer within seven calendar days, not counting Sundays and legal holidays. It gives your business, the employee's name, age, sex and occupation, and the date, nature, circumstances and cause of the injury.

The DIA counts full or partial days, and they do not have to be in a row. Shorter disabilities are medical only claims that go to your insurer, not the DIA.

Online only, and the fine

The DIA takes the Form 101 online only, through a DIA account, and gives you a transmittal number to keep. Three or more violations of the reporting section in a year bring a 100 dollar fine for each. The DIA can also ask for later reports on the employee's condition and payments.

The employee's notice

A claim needs notice to the insurer or employer as soon as practicable after the injury, and must be filed within four years of the employee learning the disability is work-related.

From field notes to a finished Massachusetts report

Note what happened and why, the body parts, and every full or partial day of disability. ReportDraft writes up the nature, circumstances and cause the Form 101 asks for and keeps fields for the disability days and the Form 101 transmittal.

Common mistakes

  • Counting only consecutive days off toward the five days.
  • Sending the Form 101 to the insurer but not to the employee.
  • Trying to file a paper Form 101.
  • Losing the DIA transmittal number.
  • Sending a medical only injury to the DIA instead of the insurer.

Sources

Last reviewed October 15, 2026. Next review due January 15, 2027. This page explains published rules to help you write your report. It is not legal advice; the official text linked above governs.