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A recent item in the news about the Missouri Attorney General's office levying fines totaling over $100,000 against two national third party administrators (TPA) for the failure to file the Report of Injury form on some workers compensation claims has caught the attention of insurers and TPAs alike.
Almost all jurisdictions require that some or all workers compensation claims be reported to the appropriate state workers compensation board, industrial commission or other state supervisory office. The name of the reporting form varies, but most states refer to it as the Employer's First Report of Injury. The requirements as to which workers compensation claims are reported to the state vary. Some states, for example – Colorado, require every work comp claim to be reported, while other states only require indemnity claims to be reported. Missouri requires every workers compensation claim, except those claims involving first aid with no further medical care, be reported. (WCxKit)
Each state has its own version of the Employer's First Report of Injury form (with varying names), which can usually be found on the states website. Each state also assigns their own form number to the Employers First Report of Injury form. In some states it is known as the E-1 or the WC-1 or the 1A. While most states will still accept a paper copy of the Employer's First Report of Injury, all the states are now encouraging the electronic filing of the Employer's First Report of Injury form.
The states also vary in who is responsible for filing the Employer's First Report of Injury. In most states, it is the employers responsibility to file the Employer's First Report of Injury. In Missouri, it is called the Report of Injury, where it is the responsibility of the insurer or the TPA to file the Report of Injury with the state after the employer has reported the claim to them. In the states where it is the employer's responsibility to complete the Employer's First Report of Injury, most of those states will allow or even require the employer to send the Employer's First Report of Injury form to the insurer or TPA, and allow or require the insurer or TPA to submit the form to the state.
The information the employer/insurer/TPA places on the Employer's First Report of Injury form is fairly consistent from state to state. The information needed to report the claim to the state will include:
1. The employer's name and address
2. The employer's federal tax ID number
3. The nature of the employer's business
4. The employer's insurance company name/self insurer name and policy number
5. The insurance company's claim number or the TPAs claim number
6. The insurance company's address and phone number, or the TPAs address and phone number
7. The employee's name and address
8. The employee's social security number, or green card number, or employment visa number
9. The employee's date of birth
10. The employee's occupation
11. The employee's telephone number
12. The date of the injury or illness
13. The machine, tool or object causing the injury
14. The nature of the injury or illness
15 .The body part(s) affected
16. A description of the occurrence
17. The medical providers name and address
18. If the accident was fatal, the employees martial status
Some states also require the Employer's First Report of Injury to contain income benefit information including:
1. Date disability / inability to work began
2. Employee's average weekly wage
3. Employee's weekly benefit
4. Date of first indemnity payment
5. Type of first indemnity payment temporary total disability, temporary partial disability, permanent partial disability
Upon receipt of the Employer's First Report of Injury, the state supervisory office will issue their own board claim number or jurisdiction claim number or other identifying number to track the claim in their own system. Some states require the insurer or TPA to send a copy of the Employer's First Report of Injury form to the employee, while other states will send the employee their own information packet. (WCxKit)
Almost every jurisdiction has a penalty or fine that can be imposed for the failure to file the Employer's First Report of Injury form. The purpose of the penalty or fine is to encourage employers to comply with the law on reporting claims to the state, not to collect revenue from employers, insurers or TPAs. However, as the Missouri cases reflect, the states can (and should) enforce compliance with the reporting requirements. Every employer should take time to be familiar with the Employer's First Report of Injury form and know the law within their state as to whom and when they should submit the Employer's First Report of Injury form.
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com or 860-553-6604.
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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
SUBSCRIBE: Workers Comp Resource Center Newsletter
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com.
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