Report an Injury

Step 1: Get Proper Medical Care. For an emergency, call 911. For non-emergencies, seek medical attention as soon as possible. Bring the Medical Status form  with you when you see a medical provider. 

Step 2: Know the facts of the accident. Talk to your employer. Discuss the how, when and where of the accident.

Step 3: Fill out the First Report of Injury Form. For starters, we strongly recommend doing this and filing it within 24 hours of a reported accident with your employer. A supervisor or appointed representative must fill out a First Report of Injury form with you—state law requires it. Be as complete as possible, and sign the form with your employer. Legally, your employer must submit your claim within six days of being notified about an injury or occupational disease. See further instructions below.

Step 4: Return to Work. Begin the process of coming back to work as soon as it's medically appropriate. For more information on getting back to work, visit www.safemt.com.

Form Instructions

> Online Reporting (Employer): Visit our First Report of Injury App Online to submit a claim. You will need your policy holder number.

> Paper Reporting (Employer or Employee). Download the First Report of Injury form and print or type your information. Then sign the form and return it to us via fax or mail:

Fax: 406-495-5020
Mail: Montana State Fund
P.O. Box 4759
Helena MT 59604-4759

> Telephone Reporting (Employer or Employee). Call 800-332-6102 and a customer service specialist will complete the First Report of Injury Form with you over the telephone.

What else should you know? Follow these guidelines for an easier claim process. 

  • Report an on-the-job injury as soon as it happens to a designated staff person or supervisor, and file the First Report of Injury Form immediately thereafter. Injured employees must report the accident within 30 days of the date of the injury to the employer. Claims must be submitted within 12 months from the date of the accident. Once you have submitted your claim, your employer has six days to notify the insurance carrier.
    • Report even minor injuries to your employer whether or not medical treatment is sought.
  • Occupational disease claims must be presented to your employer, employer's insurer, or the Department of Labor and Industry, within one year of the date you knew or should have known that the condition resulted from an occupational disease.
  • A claim does not exist until the form is signed by you and sent to Montana State Fund.
  • A claim for workers' compensation benefits may be submitted by the employee, or by a legal representative if the employee is unable to submit the claim.