Workers compensation claims

• It's your responsibility to notify us of all employee injuries as soon as the injury occurs.
•  
• Gather the facts
  • Employee's name
  • Social security number
  • Description of the accident
  • Names of any witnesses
  • Description of the injury
  
  
• Open your caim kit
  • Refer to the states listed below and locate the state(s) you operate in or the state(s) in which the injury occurred.
  • Download the First Report of Injury document and follow the instructions on the form.
  • Get details about how to mail, fax, or call in the claim.
  
  
• Report your claim
  • 1-855-223-22801-855-223-2280
  • Fax 1-844-346-09691-844-346-0969
  • You may also mail the claim reporting form using the information in the claim kit.

How are benefit payments made?

• We pay medical and disability benefits as determined by individual state laws.
• Check with your agent or claim associate for complete details.

This is only a general description of coverages and is not a statement of contract. Details of coverage or limits vary in some states. All coverages are subject to the terms, provisions, exclusions, and conditions in the policy itself and in any endorsements.

Where can I get a claim kit?

All new and renewed policies contain a notice regarding claim kits, which provides step by step access instructions.

Select the state where your business is located for information on the workers compensation laws in that state.

The information on the right side of the page includes state required bulletins and posters that need to be printed and displayed in your place of business. On the right side of the page you will also locate the "First Report of Injury," which is YOUR RESPONSIBILITY TO USE TO NOTIFY US OF ALL EMPLOYEE INJURIES as soon as the injury occurs. You can download and print the First Report of Injury document from the same web page.

The information on the left side of the page is what you will need when reporting a claim, including phone and fax numbers and mailing address.

The forms available on this site are intended for the exclusive use of our policyholders and their agents. Claim Kits include important claims department contact information, instructions, and forms.

State Farm is working with WorkersCompensation.com to provide claim kits in order to make running your business easier.*