Please rate First Injury Report Vwc Form #3 Rev. 08-26
Page 2 holds the First Report of Injury Filing Instructions.
Electronic filing: in accordance with 16VAC30-91-20, all claims reports must be filed electronically with the Commission.
Uninsured: employers who do not have a claim administrator or insurance carrier and are unable to file electronically must submit the form directly to the Commission.
Insured: send the original form to the claim administrator for the insurance company who provided insurance coverage on the date of the occurrence, if applicable.
Preparer: the form should be typed or legibly printed, signed, and dated by the preparer.
| Question | Answer |
|---|---|
| Form Name | VWC Form 3 |
| Form Length | 2 pages |
| Fillable? | Yes |
| Fillable fields | 56 |
| Avg. time to fill out | 10 min |
| Other names | Form 3, VWC Form 3, First Report of Injury, Virginia First Report of Injury |
| Edition | Rev 08/26 |
| Issuing agency | Virginia Workers' Compensation Commission |
| Where to send | Virginia Workers' Compensation Commission, 333 E Franklin St., Richmond, Virginia 23219, for uninsured employers who do not have a claim administrator or insurance carrier and are unable to file electronically |
| Matches the agency's file | Yes, checked October 2, 2026 |
| Official source | VWC Form 3 (Rev 08/26), Virginia Workers' Compensation Commission |
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Please rate First Injury Report Vwc Form #3 Rev. 08-26
