First Report of Injury Form

Step 1: Preparer
Step 2: Employer
Step 3: Employee
Step 4: Wages
Step 5: Accident/Exposure
Step 6: Injury/Illness and Medical
Step 7: Upload Additional Documents
Step 8: Review and Submit

First Report of Injury (FROI) Form

If you have a SIF web account, please login before starting a new FROI.

What You'll Need

To make filling out this form faster, have the following items on hand:

  • Employer name
  • Employee's:
    • Name
    • Address
    • Phone number
    • Social Security number (or other type of ID)
    • Date of birth
    • Hire date (date first employed)
    • Date of injury
    • Date of disability (if available)
    • Wage and hours worked
    • Description of how the injury occurred
    • Information about the injury, including body part and type of injury
    • Type of medical treatment sought
    • Medical provider
Concerns or Additional Information

If you have any concerns or additional information, please use the comments box or attach a statement in the document upload box. Supporting documents, including work release, wage information, medical reports, witness statements, etc., may also be uploaded. You may include up to 5 additional files. Please ensure files are 4 MB or less and are PDF, TIF, JPG, BMP, or PNG attachments.

Helpful Hints
  • Review and edit information before submitting.
    • If you need to correct information after the FROI is submitted, please email the claims examiner or submit a revised form.
  • To submit a revised FROI online, select "Revised" and enter the claim number. You will need to re-enter the required information.
  • You may download a PDF after the FROI is submitted. We recommend you save a copy for your records. You may contact your claims examiner if you need a copy.

Questions about using our online FROI? Contact our website support during business hours, Monday through Friday at (208) 332-2197 from 8 AM to 5 PM MST.

If you have questions about the information required on the form or the claim process, call our Claims Team at (208) 332-2100.

Preparer Information