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RECEIVED BY CLAIMSHANDLING ENTITY FIRST REPORT OF INJURY OR ILLNESS SENT TO DIVISION DATE DIVISION RECEIVED DATE FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS COMPENSATION For assistance

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What is first report of injury?

The first report of injury is a form that employers use to report workplace injuries or illnesses to the appropriate state agency and insurance company.

Who is required to file first report of injury?

Employers are required to file the first report of injury when an employee is injured or becomes ill in the workplace.

How to fill out first report of injury?

The first report of injury should be filled out with detailed information about the employee, the injury or illness, and the circumstances surrounding the incident.

What is the purpose of first report of injury?

The purpose of the first report of injury is to document workplace injuries and illnesses, ensure that employees receive appropriate medical treatment, and initiate the workers' compensation claims process.

What information must be reported on first report of injury?

The first report of injury must include information about the employee's name, address, occupation, date and time of injury, description of the injury, and any witnesses to the incident.

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