How to Fill Out and Submit the Ohio First Report of Injury (FROI)

To start an Ohio workers’ compensation claim, you file the Ohio First Report of Injury form, officially the BWC-1101, with the Ohio Bureau of Workers’ Compensation within one year of the injury. The form has four parts: a section you complete, a section for your treating doctor, a section for your employer, and (if applicable) extra fields for self-insuring employers. Once BWC receives a completed form, a claim number is issued and the clock starts on a decision.

Where to Get the Form

The BWC-1101 is a fillable PDF on the BWC website at bwc.ohio.gov. You can also get a copy from your employer’s human resources department or from the doctor’s office treating your injury.¹ The current revision date on the form is February 13, 2026.²

If your employer gives you an internal accident report, fill it out, but understand that an internal form does not open a BWC claim. Only the FROI does that.

The One-Year Filing Deadline

Under Ohio Revised Code 4123.84, your claim is permanently barred if written notice is not filed with BWC or the Industrial Commission within one year of the injury or death.³ A year sounds like plenty of time, but delayed treatment and uncertainty about whether an injury is “serious enough” tend to eat the window. File as soon as you reasonably can.

One limited extension exists: if your employer fails to file its own required injury report, each day of that failure adds a day to your deadline, up to two additional years.⁴ Do not plan around it. Proving the employer’s failure is its own fight.

For a worker whose employer is self-insuring, ORC 4123.84 lets you satisfy the one-year deadline by giving written notice to BWC, the Industrial Commission, or the self-insuring employer itself.³

What to Gather Before You Start

Pull everything together before you open the form. Blank fields rarely cause an outright rejection, but they trigger follow-up requests from BWC that delay benefits.

Your full legal name, Social Security number, date of birth, mailing address, phone numbers, and email.
Employer name and address, your job title, date hired, hourly wage, hours scheduled the week of the injury, your regular days and hours, and the state where you were hired and supervised.
The employer’s eleven-digit BWC policy number. HR should have it. If not, use BWC’s Employer/MCO Lookup tool, which accepts a company name or federal tax ID.⁵
Accident details: date and time of injury, your start time that day, when you told your employer, a written description of what happened, and every body part affected.
Medical provider information: name, address, phone, and fax of the doctor or facility that first treated you, plus the date of initial treatment.
Work status: whether you missed any part of a workday, your last day worked, and whether you have returned.

If the injury caused a death, the form also asks for the date of death, the decedent’s marital status, and the number of dependents.²

Filling Out the Form Section by Section

The BWC-1101 has four blocks. You complete the first. The other two main blocks go to your doctor and your employer, with an extra block if the employer is self-insuring.

Injured Worker Section

This is the largest block, covering your identity, employment details, and the accident narrative. A few fields matter more than the rest.

Parts of body affected. List every body part, even the ones that seem minor. A bruised forearm alongside a hurt shoulder should both go in. Adding conditions to a claim later is possible but harder than getting them on record now.

Accident description. Write a plain, factual account: what you were doing, what happened, what hurt. “I was lifting a 50-lb box onto a shelf when I felt a sharp pain in my lower back” tells BWC far more than “I hurt my back at work.” Name the equipment, surface, or condition involved.

Will the incident cause the injured worker to miss 8 or more days from work? Missing eight or more calendar days triggers eligibility for temporary total disability compensation.⁶ If you aren’t sure, check “Yes.” Withdrawing a disability request later is easier than proving in hindsight that you should have been receiving benefits all along.

Temp agency question. If you were hired through a staffing agency, answer “Yes” and name the agency. This determines which employer’s policy covers the claim.

Sign and date the bottom of this section.²

Treating Provider Section

Your doctor or the treating facility fills in this block. It asks for a narrative diagnosis with body-part location, ICD diagnostic codes, and a critical yes-or-no question: whether the medical conditions listed are causally related to the reported work accident or occupational disease. The provider also indicates whether they are the physician of record, signs the form, and enters their BWC provider number.

If the office is unfamiliar with BWC forms, point them to this section. The causal-relationship question is the one that decides claims. A “No” there effectively sinks the case at the outset.

Employer Section

The employer enters its policy number, federal tax ID, county, and contact information. The consequential field here is a choice between “Certification” and “Rejection.” Certification signals that the employer agrees the injury is work-related, which tends to speed up approval. Rejection means the employer disputes the claim. BWC still investigates and decides on its own, but the process takes longer.

Self-insuring employers complete an additional field indicating whether the claim is medical-only or involves lost time.²

Your employer has a separate obligation of its own. Under ORC 4123.28, when an injury causes seven or more days of total disability, the employer must file its own written report with BWC within one week of learning about it and must give you a copy.⁴

How to Submit the Form

BWC accepts the completed form through three channels:²

Online at bwc.ohio.gov. Fastest option, with immediate confirmation.
Fax to 1-866-336-8352.
Mail to BWC Mail Processing Center, Attn: Claims, 30 W. Spring St., Columbus, OH 43215.

Filing online is the best option if you can manage it, because you get same-day proof of submission. Faxing is a solid alternative. If you mail the form, keep a photocopy of the signed version. Whatever route you choose, make sure the injured worker, treating provider, and employer sections are all completed and signed first. A FROI without the provider’s section can still be filed and will still get a claim number, but the medical portion will need to follow quickly.

What Happens After You File

When BWC receives your FROI, a claim number is issued and used on every piece of correspondence after that.¹ Put that number on every document, phone call, and medical record going forward.

Within seven days of receiving your claim, BWC must send written notice to both you and your employer confirming receipt and summarizing the facts you reported. After BWC sends that notice, the administrator has twenty-eight days to issue an order granting or denying benefits. If a medical examination is required by statute, that twenty-eight-day clock restarts from the date BWC receives the exam report.⁷ The realistic timeline from filing to a decision runs about five to six weeks for a straightforward claim, longer if additional medical review is needed.

Your claim also gets assigned to a Managed Care Organization, which handles the medical side: coordinating treatment, reviewing provider bills, and managing your return-to-work plan. The MCO is set by your employer’s policy, and you can look up which one covers your employer using BWC’s Employer/MCO Lookup tool.⁵

If Your Claim Is Denied

A BWC denial is not final. You can appeal to the Ohio Industrial Commission by filing Form IC-12 at a local Industrial Commission office or online through the ICON system.⁸ The Commission schedules a hearing, and you must receive at least fourteen days’ notice before the hearing date. A staff hearing officer reviews the medical evidence, your testimony, and the employer’s position, then issues a new order.

If the Industrial Commission grants your appeal, compensation begins after the order is issued, even if the employer appeals further.⁸ Appeals can continue through additional Commission hearing levels and eventually to the court of common pleas, but most claims resolve at the first or second hearing level. Organized medical records and clear support from your treating physician make a real difference at these hearings.

Retaliation Protections

Ohio law prohibits your employer from firing, demoting, reassigning, or otherwise punishing you for filing a workers’ compensation claim. Under ORC 4123.90, if your employer retaliates, you can sue in the court of common pleas in the county where you worked. Remedies include reinstatement with back pay if you were fired, compensation for lost wages if you were demoted or reassigned, and reasonable attorney fees.⁹

Two deadlines apply, and both are short. You must give your employer written notice of the claimed retaliation within ninety days, and you must file the lawsuit within one hundred eighty days of the retaliatory action.⁹ Miss either and the claim is permanently barred. If you believe your employer is retaliating, document everything and talk to an attorney quickly.

1
Franklin County Law Library. Ohio Workers’ Compensation: Injured Worker Information
2
Ohio Bureau of Workers’ Compensation. First Report of Injury, Occupational Disease, or Death
3
Ohio Legislative Service Commission. Ohio Code 4123.84 – Claims for Injury or Death Barred
4
Ohio Legislative Service Commission. Ohio Code 4123.28
5
Ohio Bureau of Workers’ Compensation. Employer/MCO Look-up
6
Ohio Attorney General. Examples of Types of Compensation
7
Ohio Legislative Service Commission. Ohio Code 4123.511 – Notice of Receipt of Claim
8
Ohio Industrial Commission. The Appeals Process
9
Ohio Legislative Service Commission. Ohio Code 4123.90