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Form first report of an injury ohio 2009-2026

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  1. Click ‘Get Form’ to open the First Report of an Injury, Occupational Disease or Death in our platform.
  2. Begin by entering the injured worker's personal information, including their last name, first name, middle initial, and home mailing address. Ensure accuracy for effective communication.
  3. Fill in the details regarding the injury, such as the date of injury/disease and a description of the accident. Be specific to help expedite the claim process.
  4. Complete the employer information section by providing the employer's name and contact details. If applicable, indicate if your employer is self-insuring.
  5. Review all sections for completeness. Once satisfied, utilize our editor’s features to sign electronically and submit directly to your employer or managed care organization (MCO).

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First Report of an Injury, Occupational Disease or Death

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Rule 4123-3-08 - Ohio Administrative Code

Dec 2, 2024 Any first report of injury will be accepted for filing in any office of the bureau, MCO, or industrial commission during working hours, andRead more

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Injury Compensation for Federal Employees Publication

When an employee sustains a traumatic injury in the performance of duty, he or she should file a report on Form CA-1. It may be filed on the paper form orRead more

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