How to File a Worker’s Compensation Claim

In the event your employee is injured on the job:

1. Complete the Employer’s First Report of Injury or Disease form for all claims. Either use the “call in” reporting system or fax the original form to the insurance company. Send a copy of this form to the State Department of Industry, Labor and Human Relations (refer to the First Report for the address).
2. Forward a copy of the First Report to us in the event of a disabling injury or death claim. We will follow up with the insurance company for their prompt handling of the claim.
3. Contact the insurance company to question the status of a claim. If you experience delays or have questions, please contact us for assistance.

After you report the claim to the insurance company, the claims adjuster will:

1. Contact the injured employee to discuss the accident.
2. Request copies of bills and doctors’ reports for medical treatment administered.
3. Contact you, the employer, if there is any lost time from work as a result of the injury.