FAQ & Contact Information

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forms and instructions

Forms cannot be filed by email/attachment, FAX or file sharing platform. If you are not a registered CompHub subscriber, limited forms are available for hardcopy filing.  Only original forms with original signatures are accepted.  Please consider registration for CompHub to access current claim information, filing forms and more.  Forms submitted must be current and as provided by the  Commission.  Altered, created/unauthorized or obsolete forms are not accepted.

  • The injured worker can file their claim online via CompHub - Employee Claim C-1.

  • The injured worker may also request a paper (hardcopy) form to be mailed to their street address via this link -

  • The Employer Designation form is available here.
    The Employer or the Carrier should use the EMPLOYER SUBSCRIBER DESIGNATION form to serve as written authorization and request to the Commission for the individual to be assigned for the Employer  in CompHub. The Employer or the Carrier understands and agrees that this assignment will enable the Employer Subscriber to establish a generic email address to which all mail from the Commission (e-notices, awards, etc.) will be directed and will permit the Employer Subscriber to assign Employer Delegates, enabling access to and for filing ability in all the employer’s Maryland claims.

Select a link category from the choices below to navigate to available forms.
Address/Information Change Forms Insurance, Compliance & Reporting
Settlement Related Forms (this page) Subpoena & Medical/Release
Claims for Death Benefits Requests for Hearing Transcripts
Voc Rehab forms not in CompHub  

The Employer's First Report of Injury (FROI/SF1) IAIABC 1A-1

 Filed by the employer or their workers' compensation insurance carrier via our
CompHub portal if registered.  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 ' Commission Forms, the Commission only accepts the FROI form prepared by and issued by the Commission, form IA-1 (r 1-1-02).

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

HEARINGS - the forms below may only be used by claimants or employers who are not CompHub subscribers.

and Funeral Benefits   Please use CompHub

Effective October 1, 2011 Labor and Employment Articles, 9-683.1 through 9-683.5, Annotated Code of Maryland (House Bill 417 - 2011 legislative session) change benefits provisions when a claim for death benefits is filed with the Workers' Compensation Commission.

Note: Certain public safety employees subject to the statutory presumption set forth in 9-503 are exempt from the death benefits provisions of Labor and Employment Article, 9-683.1 through 9-683.5, Annotated Code of Maryland.  A county or municipal corporation may elect for the death benefits provisions of Labor and Employment Article, 9-683.1 through 9-683.5, Annotated Code of Maryland, to apply to its public safety employees subject to the statutory presumption set forth in 9-503.

Employers - Go to the Dependent Claim for Death Benefits County & Incorporated Municipalities page for information specific to those employers who have the option to permanently opt-in to the new benefits provisions.

The forms below are available on our CompHub portal.

  • Dependent's Claim for Death Benefits

  • Certification of Funeral Expenses

  • Claim for Funeral Benefits Only

SETTLEMENT - Please see CompHub

Medicare Set-Aside information PDF

SUBPOENA & Medical Release  - Please use CompHub



Attorneys will update or change their contact information via their CompHub User Profile page.

Miscellaneous, Other & Statutory Filing     Back to top