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First Report of Injury
Worker's Compensation Code
Notice: Effective 6/19/2013, per HEA1320, all carriers should complete State Form 55310 and submit, along with a check, to the Worker’s Compensation Board. Self-insured employers and third party administrators do not complete the form or pay this fee as they contribute to Indiana’s fee schedule and provider fee dispute system through their application and renewal fees. This is an annual requirement and will be due each year by July 31st. Filings shall cover policy year data from the previous year. Thus, the filing in July of 2013 will cover Indiana policies written in calendar year 2012. Technical questions may be addressed to Ron Cooper at the ICRB (317-842-0483). General questions or comments should go to Linda Hamilton, Chairman of the Worker’s Compensation Board (317-232-3811).