First Report of Injury

(Formerly: Employer's Report of Occupational Injury or Disease, Form LIBC-344)
Electronic Filing Is Required
To become an Electronic Data Interchange (EDI) partner or to submit First Reports of Injury, you should be an insurance carrier, a certified self-insured employer or a third-party administrator conducting business for a carrier or self-insured employer. Employers should not be submitting a First Report of Injury directly to the Bureau of Workers' Compensation.
IMPORTANT NOTICE: In September 2013, the Bureau of Workers’ Compensation and the Workers’ Compensation Office of Adjudication will implement the Workers’ Compensation Automation and Integration System, or WCAIS.
Along with implementation of WCAIS, the Bureau of Workers’ Compensation will roll out EDI in the IAIABC Claims Release 3 format for FROI and SROI transactions.
As part of the upgrade to Release 3, the Bureau will offer users the ability to submit both FROIs and SROIs via the Web using the WCAIS system. And, the current Web portal will be dismantled at that time.

Contact Information:

EDI Business Coordinator
(717) 772-0618 ext. 642
Fax (717) 705-1629
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