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FIRST REPORT OF OCCUPATIONAL INJURY OR DISEASE



Welcome to the State of New Hampshire's workers' compensation first report of injury online filing application. New Hampshire workers' compensation law requires every employer or self-insurer to file a first report of injury with the New Hampshire Labor Department for any injury sustained by an employee in the course of their employment. This report shall be filed as soon as possible but no later than 5 days after the employer learns of the injury. Successful completion and submission of the following online form satisfies this initial requirement. More information on the requirements related to workplace injuries can be obtained using this link to RSA 281-A:53 Responsibility of Employer to Provide Vital Information.This link is to a page outside of the NH DOL web site. NH DOL assumes no responsibility for its content.

This application does NOT report any of the information or data filed on this form to the employer's workers' compensation carrier. The responsibility of filing a workplace injury claim with the employer's workers compensation carrier remains with the employer or self insurer.


Log in now if you already have a NH Department of Labor active web account.

How do I get a Web account

Filing an online First Report of Injury with the State of New Hampshire Department of Labor requires an active web account. Obtaining an active web account is fast and easy. The process requires you to complete an online registration form providing us with some information about yourself and your email address that will act as your account ID. After completing and submitting your online registration we will immediately send you an email with a link. Open the email and click on the link to verify the email address you provided. This also completes the registration process and activates your web account. Obtain a Web Account.


Click here to download a Worksheet you can print to see what information is required on the First Report of Injury form. Click this icon to download a free version of Adobe Reader. This document requires the free Adobe Acrobat Reader available by clicking on this icon.

Click here to view and edit Existing Injury Reports already submitted using your web account.

Click here to submit a new First Report of Injury on a workplace injury.

For assistance, please call (603)271-8308
Copyright 2001 State of New Hampshire


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