As the employer, it is important that you file the Form 101 - Employer's First Report of Injury/Fatality accurately and timely, otherwise you may receive a First Report Violation Notice from the Department of Industrial Accidents (DIA). The reasons for receiving this First Report Violation Notice are many, and the most common reasons are:
1. The First Report is filed late.
2. The employer erroneously does not file an Employer's First Report of Injury or Fatality - Form 101 with the DIA and only files with their insurance agent or company.
3. The employer receives a rejected form back from the department, and does not re-file the rejected form with the needed corrections.
4. The insurer sends the department either a Form 103 - Insurer's Notification of Payment or a Form 104 - Insurer's Notification of Denial in response to a report from an employer that should have been filed as a medical-only claim.
5. The DIA has made an error.






