First Report of Injury (FROI) Form
If you have a SIF web account, please login before starting a new FROI.
To make filling out this form faster, have the following items on hand:
- Employer name
- Phone number
- Social Security number (or other type of ID)
- Date of birth
- Hire date (date first employed)
- Date of injury
- Date of disability (if available)
- Wage and hours worked
- Description of how the injury occurred
- Information about the injury, including body part and type of injury
- Type of medical treatment sought
- Medical provider
If you have any concerns or additional information, please use the comments box or attach a statement
in the document upload box. Supporting documents, including work release, wage information,
medical reports, witness statements, etc., may also be uploaded. You may include up to 5 additional files.
Please ensure files are 4 MB or less and are PDF, TIF, JPG, BMP, or PNG attachments.
- Review and edit information before submitting.
- If you need to correct information after the FROI is submitted, please email the claims examiner or submit a revised form.
- To submit a revised FROI online, select "Revised" and enter the claim number. You will need to re-enter the required information.
- You may download a PDF after the FROI is submitted. We recommend you save a copy for your records. You may contact your claims examiner if you need a copy.
Questions about using our online FROI? Contact our website support during business hours,
Monday through Friday at (208) 332-2197 from 8 AM to 5 PM MST.
If you have questions about the information required on the form or the claim process,
call our Claims Team at (208) 332-2100.