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   The MD WCC Employer's First Report of Injury
(Online Form IAIABC 1A-1)

 Instructions for completing an Employer's First Report of Injury IAIABC 1A-1
Adobe® Reader PDF

The MD WCC Surgeon's Report of Injury
(Online Form SF-2)

Read and follow all instructions before accessing our WebForms.  You may print these Instructions for reference.  To utilize and submit online WCC WebForms, you must install Formatta(c) Filler free software.  Current version is 7.0 for Windows.  There is no functional version for alternative operating systems such as Mac or Linux.

Read all instructions prior to installing Formatta Filler.

Click here to download and install Formatta Filler.  Select "RUN" when prompted to download the "fillersetup.exe" and follow the on screen installation instructions.  If using a business/corporate PC, you MUST have access/rights to install software for Filler to function.  If you do not have the right to install software on your PC, please "Save" instead of "Run" and contact your IT support to install this software.  Formatta Filler is a small, light program/application.  After successful installation Filler will launch and provide a success image and Formatta will appear in your "Programs" listing.


Employer/Insurer: Employer's First Report of Injury (FROI) IAIABC 1A-1
Required form: Labor and Employment §9–707

  • Complete the online form and electronically submit it to the Workers' Compensation Commission by selecting the Submit button on the electronic form.  Instructions for completing the online Employer's First Report of Injury are linked in the menu above.

  • A copy of this form must be mailed to (updated 10/24/2011):

    Division of Labor and Industry
    MOSH Research and Statistics
    10946 Golden West Drive Suite 160
    Hunt Valley, MD 21031

    An additional copy should be sent to the employer's workers' compensation insurance carrier.

  • You may print/save the completed form after submission.  An email address is required to submit the form.  A receipt of form or notice of failure will be sent to the email address entered on the form.  All general information pertinent WCC WebForms on this page or other instructions included with specific forms are applicable.



Medical/Provider: Surgeon's Report ( WCC form SF-2)

Complete the online form (all fields require input) and submit it to the Workers' Compensation Commission by selecting the Submit button on the electronic form.  You may print/save the completed form after submission.  An email address is required to submit the form.  A receipt of form or notice of failure will be sent to the email address entered on the form.  All general information pertinent WCC WebForms on this page or other instructions included with specific forms are applicable.

All  WebForms require Formatta Filler software.  WebForms include a "Submit" button actually submit the required form and data to the Commission/WCC online via your Internet connection.   You cannot save a "copy" of a blank online WebForm to your PC for re-use.  The form must be selected from the WCC web page each time a form is submitted.  Each form in assigned a unique name with each request.  A saved completed WebForm cannot be re-submitted.  Completed WebForms can be saved for viewing or printing at any time but saved forms are viewed ONLY in Formatta Filler.  You cannot view the form in other software/programs/applications.t send a copy of the submitted/completed form to the Commission.  Forms that require or indicate that copies be sent to other parties are your responsibility to print and mail to such parties.  WebForms do not change this form requirement, the WCC will not send copies of the WebForm to the required parties.  You must Print and/or Save your form after submission since you will no longer have access to the completed form after you have closed Formatta Filler.

 WebForms' requirements are the same as paper forms submitted to the WCC.  WebForms have and meet the same legal requirements as hardcopy forms submitted.  If a form certification requires that you send a copy to all parties, you must print the form and send copies to all parties in the claim or as prescribed in the form instructions or certification of service.

Like most web-based forms, WebForms will proceed through the available data input fields.  As much as possible, the form will pre-populate with the indicated claim data from the WCC claim database.  As much as possible, the input fields will validate the information you enter- if selecting "yes" or "no" indicates you must explain or provide more information, you cannot submit the form without input into the "required" field.  Each input field will display an "information bubble" or tip when your cursor is in the field to explain the information requirements.

You must enter a valid email address on the form.  This will send a confirmation receipt with the form ID number, date and time to the indicated email indicating that the form has successfully submitted to the MD WCC.  When ready to "submit" the form to the WCC: verify the form information, select "Submit".  The results of a successful submission will display the completed form with a "time stamp" and your email address.

Problems or difficulties should be sent to Websupport via email: websupport@wcc.state.md.us