All claims, regardless of treatment, must be reported to the State of New Hampshire Department of Labor. The First Report must be filed as soon as possible after knowledge of any occupational injury or disease, but no later than five days thereafter.
If the employee’s incident resulted in four or more calendar days of incapacity to earn full wages, then a Supplemental Report of Injury Form (13 WCA) must also be filed with the Department of Labor no later than seven days after the date of injury. Please note that late reporting may result in a fine being levied by the New Hampshire Department of Labor.
Please mail the original forms or fax a copy to:
The State of New Hampshire, Department of Labor
P.O. Box 2077
Concord, NH 03302-2077
Fax (603) 271-6149