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Workers' Compensation First Report of Injury Forms

First Report of Injury forms are state specific. Click on your state to open a PDF File of the appropriate form.

Alabama (PDF)
Alaska (PDF)
Arizona (PDF)
Arkansas (PDF)
California (PDF)
Colorado (PDF)
Connecticut (PDF)
Delaware (PDF)
District of Columbia (PDF)
Florida (PDF)
Georgia (PDF)
Hawaii (PDF)
Idaho (PDF)
Illinois (PDF)
Indiana (PDF)
Iowa (PDF)
Kansas (PDF)
Kentucky (PDF)
Louisiana (PDF)
Maine (PDF)
Maryland (PDF)
Massachusetts (PDF)
Michigan (PDF)
Minnesota (PDF)

Mississippi (PDF)
Missouri (PDF)
Nebraska (PDF)
Nevada (PDF)
New Hampshire (PDF)
New Jersey (PDF)
New Mexico (PDF)
New York (PDF 1 of 2)
New York (PDF 2 of 2)
North Carolina (PDF)
Oklahoma (PDF)
Oregon (PDF)
Pennsylvania (PDF)
Rhode Island (PDF)
South Carolina (PDF)
South Dakota (PDF)
Tennessee (PDF)
Texas (PDF)
Utah (PDF)
Vermont (PDF)
Virginia (PDF)
West Virginia (DOC 1 of 2)
West Virginia (DOC 2 of 2)
Wisconsin (DOC)



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