The report form that starts the claim process is the Workers Compensation Court Form 2, EMPLOYER'S FIRST NOTICE OF INJURY

Remember that this is the EMPLOYER'S report, not the employees' report. It is the responsibility of the employer to verify the facts of the accident and report the claim. The Date of the Accident is the day a single event incident occurred. In the case of cumulative trauma it is the day the matter was reported to you.

The employee's average weekly wage is based on the earnings during the 52 weeks prior to the date of accident, including overtime.

If you are insured with an insurance carrier, give us the name of the carrier and your policy number. If you are in an Own Risk Group, give us the name of the group and the group number. If you are a self-insured employer, type in "OWN RISK" and give us your Court assigned Own Risk number.

Additional instructions follows. Call Claims & Risk Services if you have any questions or need assistance. The number in Oklahoma City is 751-0943. Out side the metropolitan area the toll free number is 1-800-725-0943.

INSTRUCTIONS FOR COMPLETING A FORM 2
EMPLOYERS FIRST NOTICE OF INJURY

This link will take you to a list of blanks that correspond to the blanks on a Form 2, Employers First Notice of Injury. Fill in these blanks as you would a Form 2. Those blanks with a dot in front are mandatory fields. These must be filled in before the form will be accepted. If a required field is not filled in, when you submit the form the field will turn yellow and the form will not be submitted until the field is filled in.

Upon completion, click on "SUBMIT" and a completed Form 2 will appear. The completed form will automatically be sent to Claims & Risk Services. You will receive a notice that Claims & Risk received it. You may print a copy to keep for your records. Claims and Risk will send a copy to the Workers Compensation Court.

Workers Compensation
Employers' First Notice of Injury Form