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Click ‘Get Form’ to open Illinois Form 45 in the editor.
Begin by entering the Employer's FEIN and the date of the report at the top of the form. Ensure all information is typed clearly.
Fill in the case or file number and indicate if this is a lost workday case by selecting 'Yes' or 'No'.
Provide the employer's name, doing business as (DBA), mailing address, email address, nature of business, and SIC code.
Next, enter details about the employee including their full name, birthdate, mailing address, email address, gender, marital status, job title or occupation, average weekly wage, and dates related to employment and accident.
Describe the accident by detailing what the employee was doing when it occurred, how it happened, and listing any injuries sustained.
Complete sections regarding medical treatment received by providing physician details and indicating if emergency treatment was necessary.
Finally, ensure that the report is prepared by signing it and providing your title and contact information before submitting it to the Illinois Workers' Compensation Commission.

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Who is exempt from workers compensation insurance in Illinois?

Illinois law requires employers to provide workers compensation insurance for almost everyone who is hired, injured, or whose employment is localized in Illinois. Sole proprietors, business partners, corporate officers, and members of limited liability companies may exempt themselves.

How long do I have to report a work injury in Illinois?

Generally, the employee must notify the employer as soon as practicable, but no later than 45 days after the accident. Any delay in the notice to the employer can delay the payment of benefits.

What is Illinois Form 45?

IC45 First Report of Injury (FROI). Section 6(b) of the Workers Compensation Act requires that you (or insurers acting on your behalf) send reports to the Illinois Workers Compensation Commission on all accidents involving more than three lost work days.

What forms do new employees need to fill out in Illinois?

OSHA definition of work-relatedness. You must consider an injury or illness to be work-related if an event or exposure in the work environment either caused or contributed to the resulting condition or docHubly aggravated a pre-existing injury or illness.

form 45

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