If the employer fails to report your injury to their insurance company, they can face legal action and a $250 fine, and the injured employee may have a case against them for this reason. There are several forms that are required for a workers’ comp case. Some workers’ comp forms include:

Accident Investigation Report.

An accident report must be filled out by the employee’s supervisor or employer immediately after the accident, so the claim can be processed.. This report will be given to the insurance company by the employer.

First Report of Injury (FROI) Form.

After the employer contacts their insurance company about their employee’s work injury, a FROI form will be filled out by the employer’s insurance company to determine if the injury sustained is work related and if the employee is eligible to receive workers’ compensation. This type of form is submitted electronically to Rhode Island’s Department of Labor and Training.

Wage Statement Form.

A wage statement form containing employee information, claim information, length of employment, type of employment (full, part-time, or seasonal), and employee earnings as well as any bonuses or overtime pay must be filled out by the employer. This will be used to determine how much weekly workers’ compensation pay will be received by the employee.

Certificate of Dependency Form.

A certificate of dependency form is used to help calculate weekly workers’ comp benefits. It contains information such as marital status, number of dependents, and maximum number of personal exemptions.

How A Workers' Compensation Attorney Can Help Your Case

Contacting an attorney immediately after being injured on the job can help your workers’ compensation case. Since cases can be complicated, an attorney can help navigate you through the process. If you employer does not file forms in a timely manner, you could have a case against them in addition to your workers’ comp case. Under a workers’ compensation claim,  you may be entitled to receive payment for lost wages, medical expenses, and disability benefits. If a family member was fatally injured on the job, you may be eligible for death benefits. Before you file a claim, consult with an attorney for an evaluation of your case.


Christopher L. Russo
Helping Rhode Island personal injury victims for nearly three decades to get the compensation they deserve.
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