If you are injured at work, one of the first documents you will be required to complete is a First Report of Injury. This is where you provide personal details and information about your accident or illness.
If you were injured on the job, the paperwork could be complex. If you make any mistakes or miss any deadlines, your Workers’ Comp claim might be denied or delayed.
Where Can I Find an FROI?
When you have an accident on the job or become ill due to something that happened in the workplace, you will need to fill out a First Report of Injury, Occupational Disease, or Death. It can be found on the Ohio Bureau of Workers’ Compensation website. You may also be able to get it from your human relations department or supervisor.
What Information Do I Need for My FROI?
You will need to provide both personal information and information about the accident or illness you sustained.
Personal Information
You need to include your name, address, and social security number on the FROI. You will also have to provide your sex, marital status, date of birth, and the number of dependents.
The first section also requests information about your wage rate, days you usually work, hours you typically work, and job title.
The Ohio Bureau of Workers’ Compensation will want to know if you have been offered or expect to receive payment for the wages for the claim from anyone other than from the BWC.
Employer Information
You will have to provide your employer’s name, mailing address, and location. You will have to detail where you were hired and in which state, as well as where you were supervised.
Accident Information
The BWC form requests information about the place of the accident and if it occurred on your employer’s premises. You will need to detail the time of injury, and the date last worked. If you returned to work, you would need that date also.
If the injury was fatal, and you are completing the form for a deceased loved one, you will need to give the date of death.
Make sure to include a description of the accident and injuries.
Signature
Make sure you sign your FROI and include the date, email address, telephone number, and work number. Without this information, your claim may be rejected.
Treatment Information
When completing your FROI, you will need information about your healthcare providers as well. You should include their name, telephone number, fax number, initial treatment date, address, and other information about them.
Your healthcare provider should fill in information about diagnoses and related codes. They should also sign your FROI form before returning it to BWC.
Employer Information
There is also a portion of your FROI form for your employer to fill out. They should include their policy number, telephone number, fax number, email address, and Federal ID number. Your employer will have an opportunity to either Certify or Reject the claim.
They should sign and date the form as well.
Contact a Workers’ Compensation Attorney for Help
If you were injured on the job, you should talk to an experienced workers’ comp attorney with Kademenos, Wisehart, Hines, Dolyk & Wright Co., LPA. Our certified workers’ comp specialists, Adrienne Hines and Victor Kademenos, can help with your questions and move your claim along.
Call us today at (419) 625-7770 or use our online contact form to reach out for a consultation.