The Commonwealth of Massachusetts Human Resources Division Workers'
Compensation Section (HRD) provides workers' compensation insurance for
Bridgewater State University employees. HRD is responsible for approving or
denying an employee's claim. Frequently Asked Questions are on the HRD website
at https://www.eservices.hrd.state.ma.us/faq.html.
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 Jean Galego in the BSU Human
Resources Office, Boyden Hall, 131 Summer Street, Bridgewater, MA 02325.
-Employee Work-Related Injury/Illness Report (doc)
-Authorization for Release of Medical Records (doc)
-Concurrent Employment Review Form (doc)
( Please note: If you have no concurrent employment, write None in the space for Other Employer Name.)
Medical Treatment
Read HRD's Injured Workers' Guide to Medical Treatment for information about
obtaining approval for medical treatment.
- If you obtain 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 form directly to the address on the form or to the BSU
Human Resources Office.
Questions
If you have questions about filing a workers' compensation claim, contact Jean
Galego in the BSU Human Resources Office at 508-531-1714, by fax at
508-531-1725, or by email at jean.galego@bridgew.edu.
If you have questions after you have filed a claim, call the HRD claim unit at
617-727-3437 and ask to speak with the adjuster for Bridgewater State
University.
Last Modified: June 1, 2011