According to the Virginia Workers' Compensation Act, all injuries during employment must be reported to the Commission, as outlined in Va. Code §65.2-900. Employers are required to complete this form accurately whenever an employee is injured. The form must be filed if:
- Lost time exceeds seven days.
- Medical expenses exceed $1,000.
- Compensability is denied.
- Issues are disputed.
- The accident resulted in death.
- Permanent disability or disfigurement is involved.
- The Virginia Workers’ Compensation Commission makes a specific request.
The form should be filled out clearly and submitted to the claim administrator of the insurance company that provided coverage on the incident date.
Claim administrators capable of Electronic Data Interchange (EDI) will use the information from the paper form to submit electronic data to the Commission. Those not EDI-enabled must file the paper form with the Commission until they can submit it electronically.
| Question | Answer |
|---|---|
| Form Name | First Injury Report |
| Form Length | 2 pages |
| Fillable? | Yes |
| Fillable fields | 31 |
| Avg. time to fill out | 8 min |
| Other names | commission Virginia report, Virginia first injury report, Virginia first report of injury, VA first injury report |
