Web Submission of Claim Forms

• Forms to Report an Injury

• Claim Forms available for:
  • Attorneys/Licensed Representatives
  • Employers
  • Health Care Providers
  • Injured Workers
  • Insurance Carriers/Self-Insured Employers
  • Third Party Administrators
  • Volunteer FireFighters and Volunteer Ambulance Workers

• List of all Claim Forms Available for Web Submission

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PLEASE NOTE- You may not be able to submit claim forms to the Board during the following times due to regularly scheduled system maintanence:

• First, Third and Fifth weekend of every month.
• Every Thursday 7:30 a.m. - 8:00 a.m.
• Every Thursday from 5:30 p.m. to 7:00 a.m. Friday.

If you receive a system unavailable message during times other than these, please check the Online Services Availability Information.