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How to File a First Report of Injury

This guide shows members who do not use our FROI administration application how to report injuries online.

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How to File a First Report of Injury

Employers are required to file a First Report of Injury (FROI), within the state-mandated timeframe, for every work-related injury and illness. This guide shows members who do not use our FROI administration application how to report injuries online.

How-to-File-a-FROI.pdf

How to file a first report of injury.

PDF 1695 KB

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Template

Bona Fide Offer of Employment Template

When the doctor clears your injured employee to return to work, use this template to issue a bona fide offer of employment that meets state requirements.

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Form

Employee Acknowledgement of Alliance Direct Contracting Program

Employees must sign this form acknowledging they understand how to receive health care in the Political Subdivision Workers’ Compensation Alliance. Available in English and Spanish.

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