Report a Work-related Injury or Illness

FIRST NOTICE OF LOSS (FNOL)

Supervisor Instructions: Following is a link to a quick reference on reporting work-related injuries and illnesses. Click to download Supervisor Instructions for Workers’ Compensation Claims.

How to Report a First Notice of Loss (FNOL)

You may report a Workers’ Compensation claim two ways:

Option 1. On-line at CareMC. The supervisor is able to complete the first report via the website. Click to access CareMC. A user ID and password are required for access. To request a user ID and password, please contact Pearl Monroe at Pmonroe@mcinnovations.com.

Watch the video below, or watch it here on YouTube.

Click to learn how to change your CareMC password.

User Guides
CareMC Getting Started (Logging in, out, changing passwords)
CareMC FNOL Intake (Report an incident / injury)
CareMC Enterprise Comp Search Claims & Claim Details (Claim search and navigation)

Download the CareMC FNOL Intake for more information.

View the Location Code Directory.

Option 2. By phone 24/7 at 888 606-2562. The phone will be automatically answered “Montgomery County Self Insurance Program, first report of injury”. A telephonic first report representative will receive your call and prompt you through the questions necessary to complete the report. The representative will complete the FNOL, electronically forward a copy to the MCSIP claim office and return a copy to the reporting individual, if requested.

Click to download How to Report Employee Work-Related Injuries/Illnesses. The “How To” document is a tool to assist you in organizing information prior to making your call. The following items are a few of the key questions asked:

  • Agency name, address and location code (if known)
  • Agency name, address and location code (if known) – View the Location Code Directory
  • Injured employee’s full name, date of birth, and social security #
  • Date the accident occurred
  • Location of the accident and any witnesses
  • Your description of the accident, please start with “Employee states” (remember, this is the employer’s report of the accident)
  • Name and address of all medical providers
  • Date of Hire
  • Is the injured employee a member of a Union, if so, which one
  • Is the Injured Employee opting to treat with a Workers’ Compensation Network Physician and within the Manage Care Program

Questions? Call MCI at (703) 817-0407.

Information Cards

If you need a supply of preprinted cards, please click here and advise how many and the correct name and address to send the cards.