Which form is used to report a work injury to the insurer to initiate disability benefits?

• A. Employer's First Report of Injury (5020)
• B. Notice of Injury Claim (5010)
• C. Wage Statement Form (W-1)
• D. Medical Release Form (MR-2)

Answer: (A)

Disability benefits begin when the insurer is notified about the injury, and that notification comes through the employer’s formal report. The Employer’s First Report of Injury (Form 5020) is the document designed for this purpose. It provides the essential details the insurer needs to open a claim: who was injured, when and where the injury occurred, the nature of the injury, the body part affected, and whether the injury caused disability. Filing this report promptly starts the claim with the insurer, which triggers the eligibility review and the initial disability benefits process.

The other forms serve different roles. A Wage Statement (Form W-1) is used to verify earnings to calculate temporary disability benefits after the claim is opened. A Medical Release Form (MR-2) is for obtaining patient consent to release medical records, not for reporting the injury. A Notice of Injury Claim (Form 5010) can be involved in claim communications, but the crucial step to initiate benefits is the employer’s first report of injury.