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NOTICE -The WCIO updated the Injury Description Tables used to reflect specific coding in response to COVID-19.  The WCIO approved the addition of a new Cause Code of 83 for Pandemic and a new Nature Code of 83 for COVID-19. The WCC began accepting these codes effective 4/1/20 and are to be used for the reporting for any claim effective December 2019 or later.
The Employers' First Report of Injury (IAIABC IA-1) is filed by the employer or their workers' compensation insurance carrier via our CompHub portal.

IMPORTANT NOTICE: The Commission will temporarily accept this form in paper but the paper submission must be exactly as published on this WCC website and must be at 100% in size (no scaling) with no modifications or customizations.   This form must also be printed on 8.5 x 11 inch paper with .5 inch margins on all sides. No other versions of this form will be accepted. For timely processing, the Commission recommends that the community utilize the FROI process on CompHub.

The injured worker will file the Employee Claim Form C-1.

A First Report of Injury (FROI) must be filed by the employer/insurer with the Workers' Compensation Commission.  In accordance 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).

The QuickStart guide is posted to our Reference Materials list.

The training video is available at our Knowledge Center
 
The fields: Type of Injury/Illness, Date of Death (if applicable) and Initial Treatment must be completed and are required by Maryland Occupational Safety and Health (MOSH), a unit of the Division of Labor & Industry. If these and all other required fields are not complete or on a form other than the Commission's, the FROI will be returned. Please see the complete list of acceptable WCIO Type of Injury/Illness codes


Medical/Provider: Surgeon's Report ( WCC # SF-2)

Open the online MDWCC Surgeon's Report of Injury Form. 

Complete the online form (all fields require input) and submit.

Technical problems or difficulties should be sent to comphubsupport@wcc.state.md.us