Accident Report

As an employer, the state of Indiana requires that you follow certain rules when an employee reports an on-the-job injury or a condition they believe has occurred as a result of their employment.

The employer is required to complete a First Report of Injury as soon as possible after an employee informs you of their injury / condition but no later than seven days after receiving notice from your employee.

As long as you have filed a First Report of Injury that we can verify with your workers’ compensation carrier, we can schedule your employee with the following information:

If you have NOT yet filed a First Report of Injury OR if we cannot confirm that it has been filed, your employee can still be scheduled.


As the employer, you will be required to complete an Employer’s Authorization Form.

Depending on information we receive from the workers’ compensation carrier, or if no report has been filed, the employer will be required to pay at the time of service.  Once the workers’ compensation claim is confirmed, you will be refunded any monies paid out of pocket.

Call 574-968-2832 with any questions or to schedule an appointment.