Your Workers’ Comp

Resource Hub

Looking for a claims form? Need to order a safety poster? Maybe you need to look up your state’s notice posting requirements or need to find a sample drug testing policy? Explore below for quick access to all of the claims and safety info that you go to the most and also some resources that might help you before a claim happens.

Notice
Requirements

If your business is required to provide workers’ compensation coverage, most states require that a poster be displayed in a conspicuous location for your employees to be informed of their workers’ compensation rights. Some states require that notice of coverage also be provided directly to employees. Quick access to each state’s required workers compensation notices can be found below.

State Is Notice Required? Required Notice Form Name Link
Alabama Yes
  • WCC#1: Workers' Compensation Notice
 Workers Compensation Archives - Alabama Department of Labor
Arkansas Yes
  • Form P - Workers' Compensation Instructions to Employers and Employees
 Arkansas Worker's Compensation Commission » Forms
Georgia Yes
  • WC-BOR: Bill of Rights for the Injured Worker - English
  • WC-BOR: Bill of Rights for the Injured Worker - Spanish
  • WC-P1: Official Notice - Workers' Compensation Panel Posting Notice - English
  • WC-P1: Official Notice - Workers' Compensation Panel Posting Notice - Spanish
 Board Forms | State Board of Workers' Compensation
Iowa No
  • Not Applicable
 Not Applicable
Kansas Yes
  • K-WC 40-A: Workers' Compensation Rights and Responsibilities - English and Spanish
  • K-WC 27-A - Information for Injured Employees - English
  • K-WC 27-A - Information for Injured Employees - Spanish
 Guides and Forms | State of Kansas Department of Labor, KS
Louisiana Yes
  • Workers' Compensation Poster - English
  • Workers' Compensation Poster - Spanish
  • Workers Compensation Fraud Poster
 Resources - Posters - Louisiana Works
Mississippi Yes
  • Workers Compensation Notice of Coverage - English
  • Workers Compensation Notice of Coverage - Spanish
 mwcc.ms.gov/#/forms
Missouri Yes
  • WC-106: Workers' Compensation Law - English
  • WC-106: Workers' Compensation Law - Spanish
 Mandatory Posters/Notices | Missouri Department of Labor and Industrial Relations
Nebraska No
  • Not Applicable
 Not Applicable
North Carolina Yes
  • Form 17: Workers' Compensation Notice (and Instructions) to Injured Workers and Employers - English
  • Form 17: Workers' Compensation Notice (and Instructions) to Injured Workers and Employers - Spanish
 N.C. Industrial Commission Forms
Oklahoma Yes
  • CC-Form-1A: Workers' Compensation Notice and Instruction to Employers and Employees - English
  • CC-Form-1A: Workers' Compensation Notice and Instruction to Employers and Employees - Spanish
 Forms | OK WCC
South Carolina Yes
  • Workers' Compensation Compliance Poster
 Compliance Poster | Workers' Compensation Commission
Tennessee Yes
  • LB-0922: Workers' Compensation Insurance - English
  • LB-0922: Workers' Compensation Insurance - Spanish
  • LB-0922: Workers' Compensation Insurance - Korean
 Required Posting Notice
Texas Yes
  • Notice 6: Notice to Employees Concerning Workers' Compensation in Texas - English
  • Notice 6: Notice to Employees Concerning Workers' Compensation in Texas - Spanish
  • Notice 6: Notice to Employees Concerning Workers' Compensation in Texas - Vietnamese
  • New Employee Notice - English
  • New Employee Notice - Spanish
  • New Employee Notice - Vietnamese
 Workers' compensation employer forms and notices
USL&H Yes
  • Form LS-241
 This form is provided when the policy is issued. Please contact Stonetrust if you need a replacement.

Claim Forms

Most states require that injuries be reported electronically to the state within a specified time period. If you are unable to submit a claim through the Policyholder Portal or if you prefer to submit a claim through email, please use the forms below and email the completed form to our office – even if the form’s instructions state that the form should be sent to the state workers compensation office. We will take care of everything from here!

State Form Name Link
Alabama WCC Form 2 – Employer's First Report of Injury or Occupational Disease Alabama FROI
Arkansas Form 1 – Employer's First Report of Injury or Illness Arkansas FROI
Georgia WC-1 – Employer's First Report of Injury or Illness Georgia FROI
Iowa Form 14-0001 – First Report of Injury or Illness (FROI) Iowa FROI
Kansas K-WC 1101-A – Employer's Report of Accident Kansas FROI
Louisiana LW-WC IA-1 – First Report of Injury or Illness Louisiana FROI
Mississippi MWCC - WORKERS' COMPENSATION - FIRST REPORT OF INJURY OR ILLNESS Mississippi FROI
Nebraska NWCC Form 1 – First Report of Alleged Occupational Injury or Illness Nebraska FROI
North Carolina Form 19 – Employer's Report of Injury or Occupational Disease North Carolina FROI
Oklahoma WORKERS' COMPENSATION - FIRST REPORT OF INJURY OR ILLNESS Oklahoma FROI
South Carolina WCC FORM 12A – S.C. Workers Compensation Commission – First Report of Injury or Illness South Carolina FROI
Tennessee LB-0021 – EMPLOYER'S FIRST REPORT OF WORK INJURY OR ILLNESS Tennessee FROI
Texas DWC001 – Employer's First Report of Injury or Illness Texas FROI
USL&H LS 201 – Notice of Employee's Injury or Death LS-201
USL&H LS 202 – Employer's First Report of Injury or Occupational Disease LS-202

SAFETY RESOURCES

Posters

Posters promoting workplace safety are available to Stonetrust policyholders. Click below to view and request safety posters today.

Request A Poster

Videos

Hundreds of safety videos are available through Stonetrust’s Safety Connection to assist our policyholders with training and accident prevention. Click below to access the Safety Connection Portal.

View Video Library

Disclaminer

Any resources contained herein or otherwise provided by Stonetrust are intended to be used for informational purposes only and/or for guidance. No guarantee is made as to the appropriateness, completeness, or availability for use in any location, except as otherwise indicated, and the access to or use of these resources does not create a professional relationship. The information contained in these resources does not contain legal opinions. Neither the resources nor the content contained therein are intended to provide or act as a substitute for legal advice, and nothing contained therein should be considered to constitute legal advice. You are strongly encouraged to seek competent advice from qualified legal counsel prior to making any decisions related to any information contained in any resource provided by Stonetrust.