Work comp: First Report of Injury (FROI) form information
The employer is responsible for completing the First Report of Injury (FROI) form and submitting it to its workers' compensation insurance company within 10 days of the first day of disability or the date they were aware of disability, whichever is later.
-
If the employer is unable or refuses to file this form, the insurer is responsible for electronically submitting the completed FROI form upon request from the department.
The insurance company or self-insured employer must electronically 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. The FROI form must be filled via electronic data interchange (EDI) or the eFROI Web portal, with a copy retained for the insurer's or self-insured employer's records.
Deaths and serious injuries must be reported to the department within 48 hours. This can be done via telephone, facsimile or electronic transmission, to be followed by the FROI form within seven days of the occurrence.
The employer must also send a copy of this form to the employee. Note: Always attach a Minnesota workers' compensation system employee information sheet and retain a copy of the FROI form for its records.
If the employer is unable or refuses to file this form, the insurer is responsible for electronically submitting the completed FROI form upon request from the Department of Labor and Industry (DLI).
The insurer uses the FROI form to begin the claim process. DLI uses the information supplied via the FROI form to review for compliance with the statutes and rules, and for statistical data.
The following statutes and rules contain timelines and requirements:
-
Minnesota Statutes 176.231, subds. 1, 2 and 10 (timelines for reporting);
-
Minnesota Statutes 176.231, subd. 11 (substitute filing);
-
Minnesota Rules 5220.2530 (required information); and
-
Minnesota Rules 5220.2820 (penalties).