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Report a Claim

Alabama Self-Insured Worker's Comp Fund

Any work-related injury should be reported immediately to Employer's Claim Management, Inc, using the Employer's First Report of Injury Form. For complete instruction, please review our Claim Reporting Procedures.

First Report of Injury Form

• First Report of Injury Form
• Instructions First Report of Injury
• Nature, Part & Cause Code Search

Please fax or email your First Report Form to:

Employer's Claim Management, Inc.
P.O. Box 5614
Montgomery, AL 36103-5614
Fax: 334.277.5134
Email: firstreport@employersclaim.com

If the injury involves a fatality or catastrophic injury, call 1.800.392.1551

First Report of Injury - Electronic Submission Option
Claims may be submitted electronically through the CompInfoCenter.