Submit Workers Compensation - First Report of Injury or Illness

Step 1:  Overview
This process will walk you through 6 steps to submit the claim form.   On each screen, supply the requested information and press the CONTINUE button at the bottom.   Your claim will not be submitted until you have completed all 6 steps and a claim number has been returned.    

Do NOT press the BACK button on your browser after starting to enter claim.   If a mistake is made, you must return to this screen and start the claim over.

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