Report your injury to your employer immediately — Florida has a 30-day reporting requirement for employees

Florida uses a managed care system — you must see authorized providers

If your claim is denied, you can file a Petition for Benefits with the Office of the Judges of Compensation Claims

Workers' Compensationmoderate

Florida First Report of Injury or Illness

DFS-F2 · Florida Division of Workers' Compensation

Florida's first report of injury or illness form. Employer must file within 7 days of knowledge of an injury or within 24 hours if the injury results in death.

Form Details

Total fields: 40
Auto-fillable: 25 (63%)
Time without BeneFill: 25 minutes
Time with BeneFill: 7 minutes
Time saved: 18 minutes
Filled by: patient
Frequency: per incident
State-specific: Yes — form may vary by state

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Where to Submit This Form

📬

Employer/insurer files with FL Division of Workers' Compensation

The employer is typically responsible for filing the First Report of Injury with their insurance carrier.

🌐

FL DWC Electronic Filing

https://www.myfloridacfo.com/division/wc/employee/

Some carriers accept electronic filings.

Filing Deadline

Employer must report the injury within 7 days of knowledge. Employee should report to employer immediately.

Required Attachments

📎 First Report of Injury/Illness (DFS-F2)
📎 Medical documentation of the injury
📎 Employee and employer information

Processing Time

The carrier has 120 days to accept or deny the claim. Initial medical treatment should be authorized promptly.

What Happens Next

The insurance carrier will assign a claims adjuster and authorize initial medical treatment. You will be directed to an authorized treating physician.

Tips for This Form

✓ Report your injury to your employer immediately — Florida has a 30-day reporting requirement for employees
✓ Florida uses a managed care system — you must see authorized providers
✓ If your claim is denied, you can file a Petition for Benefits with the Office of the Judges of Compensation Claims
✓ More info: https://www.myfloridacfo.com/division/wc/

More Workers' Compensation Forms

First Report of Injury (Generic FROI)

FROI · State Workers' Compensation Agencies

Report of workplace injury or occupational disease filed with the state agency and insurer. Required within 3-10 days of injury depending on state. Establishes the claim in the system.

California Workers' Comp Claim Form

DWC-1 · California Division of Workers' Compensation

Employee claim form for workers' compensation benefits in California. Employer must provide within one working day of learning of a workplace injury or illness.

New York Employee Claim

C-3 · New York Workers' Compensation Board

Employee's claim for compensation filed with the NY Workers' Compensation Board. Must be filed within 2 years of the accident or within 2 years of when the claimant knew or should have known the condition was work-related.

Texas Employee's Claim for Compensation

DWC-041 · Texas Department of Insurance, Division of Workers' Compensation

Employee's claim for compensation for a work-related injury or illness in Texas. Must be filed within one year of injury or within one year of when the employee knew or should have known the condition was work-related.

North Carolina Notice of Accident to Employer

Form 18 · North Carolina Industrial Commission

Notice of Accident to Employer and Claim of Employee. Must be filed when injured on the job in North Carolina. Written notice to employer required within 30 days; claim filed within 2 years.

Employer's First Report of Injury (Longshore)

LS-202 · U.S. Department of Labor (OWCP)

Employer's First Report of Injury or Occupational Illness under the Longshore and Harbor Workers' Compensation Act. Must be filed within 10 days of injury.

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Disclaimer: BeneFill™ provides form-filling assistance and informational guidance only. It is not affiliated with, endorsed by, or sponsored by the Florida Division of Workers' Compensation or any government agency. The information provided is for general informational purposes and does not constitute legal, medical, financial, or tax advice. Always verify form requirements and submission details directly with the issuing agency.