The Employer's First Report of Injury
(FROI) IAIABC 1A-1 PDF for print
(WCC # SF-1).
Maryland Workers' Compensation
10 East Baltimore Street
It is filed by the
employer or their workers' compensation insurance carrier via our
injured worker will file the Employee Claim Form C-1.
Report of Injury (FROI) must be
filed by the employer/insurer with the Workers' Compensation
Commission. In accordance with COMAR 14.09.01.02 ' Commission Forms, the
Commission only accepts the FROI form prepared by and issued by the
Commission, form IA-1 (r 1-1-02).
At this time, please use a
hardcopy WCC form SF1[ IA-1 (r 1-1-02)} and mail to us.
fields: Type of Injury/Illness, Date of Death (if applicable) and
Initial Treatment must be completed and are required by Maryland Occupational
Safety and Health (MOSH), a unit of the Division of Labor &
Industry. If these and
all other required fields are not complete or on a form other than
the Commission's, the FROI will be returned. Please see the complete
list of acceptable WCIO Type of Injury/Illness codes