Which form is used to report a work injury by the employer?

• A. Employer's First Report of Injury (5020)
• B. Employee's Injury Report (EIR)
• C. Medical Report Form (MR-1)
• D. Wage Statement Form (WS-1)

Answer: (A)

The Employer's First Report of Injury is the official notice used by the employer to report a work-related injury or illness. This form, often referred to as 5020, is filed with the workers’ compensation insurer and the Division of Workers’ Compensation to open the claim. It captures essential details such as who was injured, when and where the injury occurred, what happened, the injured body part, and wage information. Filing this report promptly starts the claim process and triggers entitlement to medical care and benefits such as temporary disability if applicable.

Internal Employee Injury Reports are typically used for the worker’s own records or internal tracking, not the formal claim filing with the insurer. Medical reports, like the Medical Report Form, are completed by the treating provider to document medical status and treatment. Wage Statement forms are used to verify wages for benefit calculations but do not initiate or report the injury itself.