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NOTICE -The WCIO has updated the Injury Description Tables used to reflect specific coding in response to COVID-19.  The WCIO approved the addition of a new Cause Code of 83 for Pandemic and a new Nature Code of 83 for COVID-19. The WCC will begin accepting these codes beginning 4/1/20 and are anticipated to be used for the reporting for any claim effective December 2019 or later.
Read and follow all instructions before accessing our WebForms.
You must install Formatta(c) Filler free software to use our Online Forms.  Formatta Filler is available only for Windows. Click here to download and install Formatta Filler.  Updated 11/2016
Select "Save As" when prompted and save the downloaded file to your Desktop.  Right-click on the "fillersetup.exe" file and select "Run as administrator". Follow the on screen installation instructions.  If using a business/corporate PC, you MUST have Administrator rights to install software for Filler to function.  If you do not have permissions to install software on your PC, please "Save" instead of "Run" and contact your IT support to install this software.  After a successful installation Filler will launch with a success image and Formatta will appear in your "Programs" list.

The Employer's First Report of Injury (FROI) IAIABC 1A-1 (WCC # SF-1) is filed by the employer or their workers' compensation insurance carrier.  The injured worker will file the Employee Claim Form C-1.

A First 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).

The 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 Updated 3/2020 for COVID-19 below.  These fields are provided on our online FROI.


Medical/Provider: Surgeon's Report ( WCC # 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. 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.

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