Maryland Injury Report Form
Description
How to fill out Injury Report Form?
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FAQ
A First Report of Injury (FROI) must be filed by the employer/insurer with the Workers' Compensation Commission. In ance with COMAR 14.09. 01.02 ' Commission Forms, the Commission only accepts the FROI form prepared by and issued by the Commission, form IA-1 (r 1-1-02).
A claim for an accidental injury must be filed with the Commission within 60 days after the date of the accident, but failure to file a claim within this time frame may be excused by the Commission if the employer-insurer was not prejudiced by the failure to file in time.
Likewise, if the company owner is a sole proprietor or a partner in the business, they are not required to carry or be covered by workers' compensation. However, they can choose to purchase a policy if they wish.
The employer is required to file an Employer's First Report of Injury or Illness [DWC FORM-001 Rev.
Every physician who treats an injured employee must file a complete Form 5021 Doctor's First Report of Occupational Illness or Injury (DFR) with the employer's claims administrator within five days of the initial examination.
Filing Your Claim Before the Commission For accidental personal injuries, Maryland employees have sixty days after the injury date to file a claim before the Commission. If the accident results in death, the employee's family has eighteen months after the death to file their claim.
Filing a Comp Claim Online with the Maryland WCC The Employee's Claim Form is filed online. Once it is filed electronically, the Claimant must sign the original Form. The original Claim Form, with signature, must be sent to the Workers' Compensation Commission (WCC) within ten days of the electronic filing.
Generally, if a covered employee is temporarily totally disabled due to an accidental injury or an occupational disease the employer or its insurer shall pay to the covered employee compensation that equals two-thirds of the average weekly wage on the covered employee, up to a maximum of the average Maryland weekly ...
