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How to Report an Injury and File a Workers' Compensation Claim

  1. Should you become injured on the job, seek immediate medical attention (first aid or visit a medical provider), if necessary.
  2. Request an accident report form (ARFIE-SI) from your supervisor or Human Resources Department or download it from the website.
  3. Complete pages 1, 2, and the first half of page 3 of the ARFIE-SI. Make sure to indicate if you sought or plan to seek medical treatment on the top of page 2.
  4. Forward the completed form to your direct supervisor for completion of the form's final section.
  5. Supervisor shall then fax the completed forms to (614) 525-5715 or email the completed form to Risk Management: Jerry Bower -
    or Jenell Williams -
  6. Supervisor shall place a follow up phone call to 614-525-4642 to alert Risk Management of a new claim filing. Please provide the following information:
    • The supervisor's name and phone number
    • Employing agency
    • Name of injured person
    • Brief description of employee's injury
  7. The back pages of the County's Injury Packet lists local BWC certified physicians and treatment locations. To locate a complete listing of all workers' compensation certified physician, log on to

Note: In cases of severe injury that incapacitate an employee(s), the supervisor shall perform steps 2 through 5 and provide as much information known to the supervisor at this time.