DON’T SIGN MASSACHUSETTS 105 WORKERS COMPENSATION FORM
Don’t Sign Massachusetts Form 105 Workers’ Compensation Form: Protect Your Benefits
If you’ve been injured at work and received a Form 105 from your employer’s insurance company, stop immediately. Signing this document could cost you your workers’ compensation benefits and leave you financially stranded. At Markey Law Partners, we’ve seen too many injured workers fall victim to this legal trap. Here’s why you should never sign Form 105—and how we can help protect your rights.



What Is Form 105?
Form 105, officially called the Agreement to Extend 180-Day Payment Without Prejudice Period, is a document insurers use to extend their control over your workers’ compensation case. Under Massachusetts law (M.G.L. Chapter 152), insurers can pay benefits for 180 days without accepting liability for your injury. This means they can stop payments at any time with just 7 days’ notice.
By signing Form 105, you grant the insurer another 180 days (360 total) to terminate your benefits without justification. This extension gives them even more power to delay, deny, or dispute your claim while leaving you vulnerable to financial instability.
Why Signing Form 105 Is a Mistake
At Markey Law Partners, we’ve handled countless cases where injured workers unknowingly signed Form 105, only to regret it later.
Here’s why signing this form is a dangerous move:
- Insurers Gain Unlimited Power to Deny Benefits
When you sign Form 105, you give the insurance company the ability to:
- Stop your payments without a judge’s approval.
- Use vague excuses like “claim investigation” or “medical review” to cut off your income.
- Force you into a lengthy legal battle while you struggle to pay bills and support your family.
- You Lose Critical Legal Protections
After the initial 180 days, insurers must accept liability if they continue paying benefits. This means they can only stop payments if:
- A judge orders it.
- You return to work with no wage loss.
- You provide a medical release.
By signing Form 105, you waive these protections, leaving you at the insurer’s mercy.
What Happens If You Refuse to Sign?
If you refuse to sign Form 105, you maintain the upper hand in your workers’ compensation case. Here’s what happens:
- After 180 days, the insurer must prove a valid reason to terminate benefits in court.
- You continue receiving payments during disputes, giving you time to build a strong case with the help of an experienced attorney.
At Markey Law Partners, we advise our clients to never sign Form 105 without consulting a lawyer first. This simple step can make all the difference in protecting your benefits and securing your financial future.
Consequences of Signing Form 105
Signing Form 105 can have devastating consequences for your workers’ compensation claim. Here’s what you risk:
- Extended Vulnerability: Insurers can terminate your benefits at any time for a total of 360 days.
- No Guaranteed Payments: Despite what the insurer may tell you, there’s no guarantee your benefits will continue.
- Permanent Loss of Benefits: If you’re unable to fight back, you could lose your benefits permanently.
At Markey Law Partners, we’ve seen firsthand how signing Form 105 can derail a worker’s claim. That’s why we’re here to help you avoid these pitfalls and fight for the benefits you deserve.
What to Do If You’ve Already Signed Form 105
If you’ve already signed Form 105, don’t panic—there’s still hope. At Markey Law Partners, we’ve helped many clients recover from this mistake. Here’s what you can do:
- Act Immediately: The sooner you contact an attorney, the better. We can review your case and determine if the agreement can be challenged.
- Challenge the Validity: If you were pressured, misled, or not fully informed about the consequences of signing, we can argue that the agreement is invalid.
- File an Urgent Claim: We’ll work to reinstate your benefits and ensure you receive the financial support you need while your case is resolved.
Our team is skilled at navigating the complexities of workers’ compensation law, and we’ll fight tirelessly to protect your rights.
How Markey Law Partners Can Help
At Markey Law Partners, we specialize in helping injured workers navigate the challenges of workers’ compensation claims. Here’s how we can assist you:
- Investigate Insurer Tactics
We’ll review your case to determine if the insurer used unfair tactics to pressure you into signing Form 105. If they did, we’ll hold them accountable.
- Block Benefit Termination
If your benefits have been cut off, we’ll file motions to reinstate them and ensure you continue receiving payments while your case is resolved.
- Secure Long-Term Relief
Our goal is to secure the best possible outcome for your case, whether that’s a lump-sum settlement, lifetime benefits, or a favorable court ruling.
- Provide Clear Guidance
We’ll explain your rights and options in plain language, so you can make informed decisions about your case.
FAQs About Form 105
A: No. If you don’t sign, the insurer loses the right to terminate benefits arbitrarily after 180 days. They must continue payments unless a judge orders otherwise.
A: This is a scare tactic. Insurers cannot legally force you to sign Form 105. Contact Markey Law Partners immediately to protect your rights.
A: As soon as possible. Insurers often send Form 105 in months 3–5 of your injury, so it’s crucial to act quickly.
Schedule a Free Consultation at Markey Law Partners Today
Signing Form 105 can have serious consequences for your workers’ compensation claim. It’s a legal trap designed to give insurers more control over your case while leaving you vulnerable to financial instability.
At Markey Law Partners, we’re here to help you avoid these pitfalls and fight for the benefits you deserve. If you’ve received Form 105—or if you’ve already signed it—don’t wait. Contact us today for a free consultation.
Your future is too important to leave in the hands of an insurance company. Trust the experienced team at Markey Law Partners to fight for you and call on 877-488-2667.
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