Get Iowa Worker''s Compensation First Report Of Injury 1998-2025

Filing the Iowa Worker’s Compensation First Report of Injury online is a crucial step for employers when reporting employee injuries. This guide will provide you with clear and structured instructions to ensure accurate and timely completion of the form.

Follow the steps to successfully complete the report.

1. Click ‘Get Form’ button to obtain the Iowa Worker’s Compensation First Report of Injury form and open it in your preferred online editor.
2. Begin by filling out the jurisdiction code and jurisdiction claim number at the top of the form. Ensure you enter the correct details as these codes will help organize the report within the state system.
3. Complete the claim administrator section, which includes the name, contact information, and mailing address of the claim administrator as well as the insurer's name if different.
4. Provide the employer's information including name, FEIN, and both mailing and physical addresses. Also, include the insured report number and policy/contract number.
5. Fill in employee details such as their full name, date of birth, gender, and date of hire. It is critical to check the tax filing status and educational level to reflect the employee's situation accurately.
6. Document the nature of the injury by describing it in detail. Additionally, specify any parts of the body affected and record the time of injury.
7. Indicate how the injury occurred, including any relevant details about the object or substance involved in causing the injury.
8. Complete the medical section by identifying if medical records were involved and providing the initial medical provider's information if applicable.
9. Review all entries for accuracy. After ensuring all information is correct, you can choose to save changes, download, print, or share the form as needed.

Begin your online submission for the Iowa Worker’s Compensation First Report of Injury today!