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.
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