New Jersey’s Workers’ Compensation Forms: Business Owners Need to Understand

New Jersey has a robust workers’ compensation procedure to protect injured employees. As a business owner in New Jersey, it’s important to know the different New Jersey’s workers’ compensation forms needed to ensure compliance with the law.

Below are some of the forms business owners need to understand. Businesses must understand their legal responsibilities under the New Jersey Workers’ Compensation Act.

These forms ensures that injured employees get sufficient compensation and that employers follow the law. Additionally, the forms provide information on how to file a case, dispute a decision, and appeal a decision.

4 Workers’ Compensation Forms For Business Owners In New Jersey

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Form 16 NJ A & 17 NJ- Workers Compensation Insurance Notice Poster

This is the “Notice to Employees of the Employer’s Workers’ Compensation Insurance Coverage” form. Employers must print the notice on 90# index paper, 8.5″ by 11″ in size.

This notice should be posted in a prominent place in the workplace. Also, in such way that all employees can see it. The message informs employees that their employer has workers’ compensation insurance coverage and provides them with detailed information about their rights and responsibilities under the law. It must be in both English and Spanish languages.

The notice should include the name of the employer’s workers’ compensation insurance carrier, the carrier’s policy number, and the contact information for the carrier. Additionally, the notice should include instructions on how to file a claim for workers’ compensation blessings.

Form 1A-1 – First Report of Injury (FROI)

This is one of New Jersey’s workers’ compensation forms. The employer should complete this form three days after receiving a work-related injury/illness. The employer must fill up the form within 24 hours in cases of death because of an accident. Usage of the form helps to initiate the workers’ compensation claims process. 

The form requires the employer to provide information about the injured employee, their name, address, social security number, and details about the injury/illness, like the date and time of the incident, the location, the witnesses present during the incident, the medical treatment the employee has received for the injury or illness and time the employee has missed work due to the injury/illness.

The employer must include a description of the work move that contributed to the injury/illness and the preventive steps taken by the employer to avoid similar incidents. Finally, the employer must certify that all the information provided is true and accurate.

Also Check: How To Calculate Workers’ Compensation Premiums: What Factors Go Into It?

Wage Statement – CL-506NJ

The form provides documentation of an employee’s wages and gross income for the past year before injury/illness. The employer should fill out the form and submit it to their workers’ insurance agency within five days of knowledge of the accident that caused their employee to be disabled for more than the seven-day waiting period.

Employees are entitled to indemnity benefits if they miss work for more than seven days. The information calculates the employee’s average weekly wage, determining the worker’s compensation benefits the employee is entitled.

The employer should keep a copy of the form for recording and provide a copy to the employee. Also, the employee should keep a copy for recording purposes. The employee should report the changes in their situation to the insurance carrier quickly.

Also Check: What Is The Maximum Amount Of Compensation In A Personal Injury Case?

Accident Investigation Report

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The supervisor/manager must complete and file an accident investigation report form with their workers’ compensation insurance carrier when an accident occurs. Employers may need to provide information about the safety measures taken during the accident and the actions taken to prevent similar accidents from occurring in the future.

The report provides detailed information about the accident. This helps to determine if the injured employee is eligible for benefits and get compensation. The insurance carrier uses the report to investigate the accident’s cause and determine if they could have taken safety measures to prevent it. If the report finds that the employer was negligent, the insurance carrier will not cover the costs of the accident.


Business owners in New Jersey must know the different workers’ compensation forms needed to manage workers’ compensation claims. Businesses must fill out and submit these New Jersey workers’ compensation forms on time. Also, this ensures that their employees receive the benefits they deserve in the circumstance of a work-related injury.

Failure to complete and submit these forms on time can lead to significant penalties or other legal repercussions for business owners in New Jersey.

Also Check: Working In The USA: Top 9 Facts All Workers Should Know First

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