Reporting Employee Injuries Is Your Responsibility

Illinois workers’ compensation policyholders can now download copies of the Employers First Report of Injury, the workplace poster, and other workers’ compensation forms from the Illinois Workers’ Compensation Commission Web site. By printing these forms from the Web site, you can be sure that you are using the most recent version of the form that is currently available.

The First Report of Injury

In the event of an employee injury, employers are required to complete the Employers First Report of Injury and send it to their workers’ compensation insurance provider immediately after the employee injury.

The report form and instructions for completing it are available online from the Illinois department’s Web site at the following link:

When you have completed the form mail, fax, or e-mail it to the address below (scan and email preferred).

   Select Church Insurance Services, Inc.
   4906 Main Street, Suite 101
   Lisle, IL 60532
   Fax: 1-630-379-0122

Workplace Posters

You also can download the poster that Illinois law requires you to display in a prominent place in employee workplaces. You will have to complete the bottom section of the poster with pertinent information about you and your workers’ compensation insurance provider. You can access the poster page directly by using the following link:

If you have questions about the requirements for submitting a workers’ compensation claim or displaying workplace posters, please contact us

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