Report an Injury
To report an injury, you can fill out the online PDF form and Submit the form online, or you can call Premier Comp directly at 1.800.776.4771. You can also fill out the online form, print and fax the completed form to 1.800.230.8935.
To fill out the online form, you MUST have Adobe Acrobat or Adobe Reader 6.0.2 or higher. You can download a FREE version of the latest Adobe Reader here. Depending on your connection speed, it may take awhile to download.
Click here to fill out the FROI (First Report of Injury). (If you receive an error processing this file, download the latest Adobe Reader or print the FROI and fax to 1.800.230.8935.)
If the injury resulted in Death, please contact the Bureau of Workers' Compensation (BWC). You can access their website here.