Work Related Injuries/Illnesses
The Commonwealth of Massachusetts Human Resources Division Workers' Compensation Section (HRD) provides workers' compensation insurance for the employees at Middlesex Community College. HRD is responsible for approving or denying an employee's claim. Answers to Frequently Asked Questions concerning Workers' Compensation may be found on the HRD Website.
The Division of Industrial Accidents, part of the Commonwealth's Department of Labor and Workforce Development, is responsible for administering the Workers' Compensation System in Massachusetts. Information about the Department of Industrial Accidents' Administration of the Workers' Compensation System maybe found on the Labor & Workforce Developments Injured Workers' Guide.
Filing a Claim
Complete the following forms to file a claim for a work-related injury or illness. Return the forms as soon as possible to: Julie Kelley in Human Resources, Bedford Campus, Cataldo Bldg., Room 118.
- Employee Work-Related Injury/Illness Report
- Authorization for Release of Medical Records
- Concurrent Employment Review Form (please note if you DO NOT have concurrent employment, write NONE in the space for Other Employer Name.)
For information about obtaining approval for medical treatment you receive as a result of a work-related injury or illness, see HRD's Injured Workers' Guide to Medical Treatment.
If you receive medical treatment:
- Complete the employee section on a Physician's Report.
- Give the Physician's Report to your medical provider to complete the medical provider and physician sections.
- Return the completed Physician's Report to Julie Kelley in Human Resources.
- Pharmacy Benefit - Temporary Prescription ID card
If you have questions about filing a Workers' Compensation Claim, contact Julie Kelley in Human Resources at 781-280-3531 or by email at email@example.com.
If you have questions after you have filed a claim for Workers' Compensation, call the HRD claim unit at 617-727-3437.