Cover Sheet and Welcome Letter
Table of Contents
Instructions for Posters
C-24 – Employer’s Posting Notice (Versión en Español)
Fraud Prevention Poster (Versión en Español)
Instructions for Injury Reports
IA-1 – Employer’s First Report of Injury
C-2 – Statement of Wage Information
Incident Investigation Report (Versión en Español)
Supervisor’s Report of Employee Incident (Versión en Español)
Witness Statement of Injury or Incident (Versión en Español)
Instructions for Injured Worker Handouts
Injured Workers First Fill Prescription Form (Versión en Español)
A-25R – Authorization for Disclosure of Health Information
Consent and Authorization for Release of Information Form (Versión en Español)
Request for Medical History Form (Versión en Español)
Instructions for Informational Documents
Omaha National Contact Information
Reduce Your Workers Compensation Costs
Claim Process Diagram
C-98 – FAQs for Employers About Maryland Workers’ Compensation Law
Instructions for General Forms
Request for Subrogation Waiver
Form ERM-14 – Confidential Request for Ownership Information
Company Contacts Verification
Instructions for State-Specific Forms & Documents
Notice of Electronic Coverage Forms
