What Is the First Report of Injury (FROI) Form?
The First Report of Injury (FROI) is the official document an employer must submit to the Texas Department of Insurance, Division of Workers' Compensation (TDI‑DWC) when an employee is hurt on the job. It triggers the benefits process, establishes the injury date, and starts the legal timeline for claims.
- What Is the First Report of Injury (FROI) Form?
- Why Prompt Filing Matters
- Key Sections of the FROI Form
- Step‑by‑Step Completion Guide
- 1. Gather Required Information
- 2. Fill Out Employer & Employee Sections
- 3. Describe the Incident Accurately
- 4. Document Medical Care
- 5. Review and Sign
- Submission Options
- Deadlines and Penalties
- Common Pitfalls & How to Avoid Them
- What Happens After Submission?
- Resources and Forms
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Why Prompt Filing Matters
Texas law requires the employer to file the FROI within **8 days** of learning about the work‑related injury or illness. Missing this deadline can delay medical benefits, jeopardize wage‑replacement eligibility, and expose the employer to penalties.
Key Sections of the FROI Form
The standard form (DW‑1) is divided into clear sections. Below is a concise breakdown of each part and the information you must provide.
| Section | What to Include | Common Errors |
|---|---|---|
| Employer Information | Company name, address, TDI‑DWC policy number, and contact person. | Leaving the policy number blank or using an outdated address. |
| Employee Details | Full name, Social Security number, job title, and dates of employment. | Incorrect SSN or misspelled name. |
| Injury/Illness Description | Date & time of incident, location, cause, and a brief narrative of what happened. | Vague descriptions; omitting the exact time. |
| Medical Treatment | Provider name, treatment start date, and whether emergency care was needed. | Skipping the provider's license number. |
| Witnesses | Names and contact information of any witnesses. | Leaving this section empty when witnesses exist. |
Step‑by‑Step Completion Guide
1. Gather Required Information
Before opening the form, collect:
- Employee's personal and employment records.
- Incident report (if you have one).
- Medical provider details and any emergency‑room paperwork.
- Names of witnesses and their contact info.
2. Fill Out Employer & Employee Sections
Enter the data exactly as it appears on official records. Double‑check spellings and numbers; the DWC cross‑references this information with the employee's claim.
3. Describe the Incident Accurately
Use a factual, chronological narrative. Include:
- What the employee was doing.
- Specific equipment or substances involved.
- Any safety measures that were in place or missing.
A precise description helps medical providers and claims adjusters assess causation.
4. Document Medical Care
Note the first provider seen, whether it was an emergency department, urgent care, or a company‑designated physician. If the employee was transported by ambulance, record that as well.
5. Review and Sign
The employer (or authorized representative) must sign and date the form. An electronic signature is acceptable if the submission is online.
Submission Options
Texas DWC accepts the FROI via three methods:
- Online portal: Most efficient; provides an immediate receipt.
- Fax: Use the dedicated DWC fax number (800‑252‑9399). Retain the fax confirmation sheet.
- Mail: Send to: Texas Department of Insurance, Division of Workers' Compensation, P.O. Box 12068, Austin, TX 78711‑2068.
Regardless of method, keep a copy for your records.
Deadlines and Penalties
Missing the 8‑day filing window can lead to:
- Late‑filing penalties ranging from $100 to $500 per day.
- Potential denial of wage‑replacement benefits for the employee.
- Increased scrutiny from DWC auditors.
If a legitimate reason prevented timely filing (e.g., the injury was not immediately apparent), document the cause and submit a written explanation with the FROI.
Common Pitfalls & How to Avoid Them
Below is a quick checklist to ensure a clean submission.
- Incomplete witness info: Even a single missing phone number can trigger a request for clarification.
- Incorrect policy number: Verify the number on your workers' comp policy certificate.
- Ambiguous injury cause: Use specific terms like "slipped on wet concrete" instead of "fell.
- Late filing: Set calendar reminders for the 8‑day deadline.
What Happens After Submission?
Once the DWC receives the FROI, they will:
- Assign a claim number.
- Notify the employee's medical provider of coverage.
- Begin the investigation to confirm that the injury is work‑related.
If the DWC requests additional information, respond promptly to avoid further delays.
Resources and Forms
Download the official form and access filing instructions directly from the Texas DWC website:
- DW‑1 First Report of Injury (PDF)
- DWC Frequently Asked Questions