
Select your state below and submit an online report of injury. Note: You will not be able to complete the submission process from saved or book marked forms. |
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Report all job-related accidents and injuries by calling 1-800-440-5020. You'll reach a live person 24 hours a day, 7 days a week. We will help arrange immediate medical treatment and answer your questions about workers' comp benefits. |
| If you need help finding a medical provider in your area, click here. |
| If you are reporting a serious or fatal claim in California, click here for Cal/OSHA reporting requirements. |
Call 911 to arrange transportation to the nearest medical facility.
Call First CallSM (1-800-440-5020) immediately.
Your policyholder number;
Description, date and time of accident;
If the employee received medical attention prior to your call to First CallSM, have the name, address and phone number of the doctor or hospital that treated the injured employee; and
The injured employee's name, address, Social Security number, date of hire, occupation, wages and date of birth.