The First Report of Injury (FROI) form is the reporting document for all work-related injury claims. It provides basic information necessary to start the claim. Deaths and serious injuries must be reported to the Department of Labor and Industry within 48 hours. This can be done via telephone, facsimile or electronic transmission, to be followed by the FROI form.
For all other injuries, where claimed disability exceeds three calendar-days, the employer must get the FROI form to its insurance company within 10 days of the first day of disability or the date it was aware of disability, whichever is later. Likewise, the insurance company must file the FROI form with the department within 14 days of the first day of disability or the date the employer was aware of disability, whichever is later. For self-insured employers, the FROI form must be filed with the department within 14 days of the first day of disability or the date the employer was aware of the disability, whichever is later. The employee must be given a copy of the FROI form, with the employee information sheet.
Employees are not responsible for completing the FROI form. It should be completed accurately, completely, legibly and timely by the employer. Again, it is very important the FROI form be submitted timely to avoid unnecessary penalties.
For injuries with claimed disability of more than three calendar-days, the insurer must make a determination regarding liability within 14 days of the first day of disability or the date the employer was aware of disability, whichever is later. This means the insurer must pay or deny a claim within 14 days. Failure to pay or deny within 14 days can result in penalties.
After payment of wage-loss benefits has begun, they cannot be stopped without giving notice to the injured employee. The insurer must advise the employee of the specific type of benefit it is proposing to discontinue, the reason for the discontinuance and the facts (including medical reports) that support the reason. This is done by filing a Notice of Intention to Discontinue Workers' Compensation Benefits (NOID) form or a Petition to Discontinue form.
Exception: If the insurer begins to pay benefits and then determine soon afterward that the injury is not compensable, the insurer may deny primary liability and discontinue benefits by filing a Notice of Insurer's Primary Liability Determination (NOPLD) form within 60 days from the first day of disability or the date the employer was aware of disability, whichever is later. If more than 60 days have elapsed, the insurer must file an NOID form to discontinue the benefits when denying primary liability.
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