$655,000 Crushing Accident
$850,000 Excavator Accident
$542,000 PTSD Claim

What is Pay Without Prejudice (Form 105)?


Workers Compensation Attorneys

An accident at work can be traumatic and painful. If you or a loved one have been injured on the job, it is important to protect yourself and talk to an experienced workers compensation attorney in Massachusetts. However, the workers’ compensation process is complicated. One error can result in denial of claims, denial of treatment, or termination of employment.

If you have contracted an illness at work, or sustained a workplace injury, our workers’ compensation attorneys at the Bellotti Law Group, P.C. can help. We have over 38 years of expertise in dealing with workers’ compensation cases. Each of our workers’ compensation attorneys are well prepared to help clients and their families receive the compensation they deserve after a work-related injury. Contact us today at 617-225-2100 for a free consultation.

Never Sign Form 105: What Is the Pay Without Prejudice Period?

Using Magnifying Glass To Check ContractThe Pay Without Prejudice Period in Massachusetts is a period where worker compensation insurers can pay disability benefits without taking responsibility. The Pay without Prejudice Period usually starts on the date of the accident, and continues for the first 180 days of disability following a work-related injury. If a workers' compensation insurer chooses to pay benefits to an injured worker voluntarily, they may pay for the first 180 days without impacting their right to contest any problem that may emerge in the workers' compensation claim.

Since the insurer has not admitted liability, the insurer has the authority to suspend or alter the payment of disability benefits during the 180-day Pay Without Prejudice Period. If the insurance company stops or changes your workers' compensation payments, they must send you a seven days’ notice. Once your benefits have been canceled or changed, you can submit a claim for disability benefits with the Massachusetts Department of Industrial Accidents.

What Is Form 105?

Insurance companies will send Form 105 for you to sign. This form extends the Pay Without Prejudice Period from 180 days to 360 days. When you sign the form, it allows an insurance provider to prolong benefits without assuming liability, and also extends the right of insurers to terminate benefits with seven days' notice. Insurance companies do not want to accept liability, so they will use Form 105 as a tool to discontinue your benefits. When you sign Form 105, you give up your legal rights, which can cause your benefits to be discontinued at any moment. Insurance companies will often claim that you should sign the form in order to continue your benefits, however, the form allows insurance companies to discontinue your benefits as long as they give you a weeks’ notice.

The form must be filed 7 days prior to the end of the PWOP. Insurance companies will often send Form 105 as soon as they are notified of your injury, and often before you can speak to an attorney. Contact an attorney before you sign any forms.

Can Insurers Automatically Accept Liability?

Can Insurers Automatically Accept Liability?Unless you have signed Form 105, insurance companies automatically accept liability if they keep paying you after the 180 day Pay Without Prejudice Period. Before terminating or modifying benefits, the workers' compensation insurer must get judicial approval. Knowing whether or not liability has been acknowledged is critical. Once responsibility is acknowledged, the insurer cannot simply cancel or change benefits.

How Does This Work?

There are a few times when signing Form 105 makes sense. An expert attorney can assist you in making the best option. Form 105 will not be legitimate without your signature, and the Pay Without Prejudice Period will not be extended for a full year. If the claim is settled without your rights or privileges being determined, relinquished, or lost, the insurer can use Form 105 to prolong your workers' compensation benefits. The employee's signature, as well as that of the judge or conciliator, validates this form.

Important Things to Remember
  • Within 3 to 4 weeks of your injury, you should start receiving benefits. Payments made within the first 180 days doesn’t mean that the insurer has acknowledged liability. Your weekly compensation may vary.
  • Your benefits may be terminated or reduced by the insurer.
  • The insurer must explain why your payments have been stopped or reduced.
  • The insurer can extend the 180 day term if necessary.
Contact Our Massachusetts Workers Compensation Attorney

Contact Our Massachusetts Workers Compensation AttorneyIt is critical to seek medical attention as soon as possible following a workplace injury. That's why the state of Massachusetts allows insurance companies to pay workers' compensation benefits before a final judgment is reached. This means insurers can pay you, but also refuse to take responsibility for your injuries. For injured workers and their families, this "pay without prejudice" period can be very stressful.

You might think that if you are injured on the job, and you are getting workers’ compensation, that you don't require legal representation. However, conditions may change rapidly. If something goes wrong, our experienced lawyers at the Bellotti Law Group will be ready to act as soon as possible. Before your situation changes for the worse, hire one of our expert attorneys to help you. Call 617-225-2100 for a free consultation today.


Client Reviews
Could not have been happier with Attorney Peter Bellotti and everyone at Bellotti Law Group. I had a very difficult case, but Peter was relentless. He saved me and my family, big time, when the situation looked very bad. I was recommended to Peter and was told he was the best attorney in Boston and now I see why, 100%. Thank you Peter! John F.
I was referred to Attorney Bellotti by a friend who works at Harvard University. I was really nervous at the beginning of my case but Peter kept me calm and was very reassuring and even gave me his cell phone number to text or call him if I really needed to get in touch with him asap… My case went extremely well and my family and I could not have been more please. I highly recommend Attorney Peter Bellotti. Beth A.
Attorney Bellotti assisted me in a Magistrate matter in Palmer District Court. He was very professional, knowledgeable, had excellent communication skills, well prepared, and new how to handle the situation. I would highly recommend Attorney Bellotti for any litigation matters and he gets the job done. Arlon B.
When looking for an attorney I didn't think have to think twice about who to call to protect my future. Peter Bellotti's amazing reputation made it an easy decision for who to call. He went above and beyond in my case, returning phone calls promptly, answering all my questions to ease my mind, and being a very understanding caring person. Patrick
I was on a case with Peter that spanned over a year and a half. Peter was very accommodating and set early expectations which helped get through this time period. Peter's professionalism helped keep me calm during this full time period. It was a pleasure getting to know Peter and if I ever need another lawyer in and around Boston Peter would be my go to choice hands down. Kyle