State Agency Links: Employers First Report of Injury

Visit the state agency Web sites to view the forms for first report of injury. ERIE will file all required reports with the state workers’ compensation agencies for you.

• District of Columbia
• Illinois
• Indiana
• New York
• North Carolina
• Tennessee

Filed electronically (no paper forms):

• Maryland
• Pennsylvania
• Virginia
• West Virginia

Refer to the list of workers’ compensation state administrative agencies for additional information.

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