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New Jersey Claims Information

Below are many of the common claim forms you will need when filing a claim in New Jersey. A complete list of all common New Jersey Workers’ Compensation forms may be found on New Jersey’s Department of Labor and Workforce Development website:

http://lwd.dol.state.nj.us/labor/wc/forms/forms_index.html

Employer Claim Information and Forms

Document What It Is When To Use/File
Welcome kit Welcome letter for employers entering the Oryx Insurance construction program. Kit includes welcome letter, contact listing and information on our loss control services. Whenever an injury occurs.
Contact Listing State specific claim contacts Use as directed
FORM IA-1(r 1-1-02) Employer’s first report of injury. ASAP after the injury occurs.
WC-373 (10/09) An Employer’s Guide to Workers’ Compensation in New Jersey General use
Pharmacy Benefits Information on the injured employee’s pharmacy benefits for all medications associated with his/her work-related injury.

If you have a question related to a claim, please call 315-410-0210

Employer’s Responsibility for Filing a Claim

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