Workers’ Compensation First Report of Injury Instructions:
If you prefer, you may submit the FROI by fax or U.S. Mail.
The First Report of Injury Instruction Page is also available for you to print if needed for further assistance. Feel free to call our Workers' Compensation Department if you need assistance completing this form.
Step 2: Complete the below forms as soon as possible. Once the forms are completed and saved to your computer, you have the option to attach them to your online First Report of Injury claim submission.
- HIPAA Medical Release Form
- Physician of Choice Form
- Work Status Form
- Wage Statement
- Mileage Reimbursement Form
If you receive an "Employee Petition to Controvert" please contact our office immediately for further handling instructions.
Step 3: If submitted online you will receive an email confirmation.