Need to report an injury? Download and fill out the Wyoming Report of Injury form completely. We encourage the injured worker and employer to work together when completing the form. Print and mail to the address below.

Wyoming Department of Workforce Services
Workers’ Compensation Division

5221 Yellowstone Road, Cheyenne, WY 82002

Mailing Address: P.O. Box 20207, Cheyenne WY 82003

(307) 777-7441

(307) 777-6552 Fax

(888) 996-9226 Fraud Hotline

Your Responsibilities When Filing a Report of Injury

You must Report your Injury to your employer within 72 hours of the accident causing your injury and within 10 days to the Workers’ Compensation Division.

Injury reports must be signed by the injured worker.

Note: A Report of Injury is not a claim for benefits. Medical bills, reimbursements and compensation claims must be applied for using the appropriate forms.

Each Report of Injury is assigned its own unique 9-digit case number. Reference this number when seeking assistance, in writing or by phone, or obtaining medical care.

After the Division receives your Report of Injury form, it must be reviewed within 15 days. If the Division is not able to make a decision on your Report of Injury because additional information is needed, you will receive an Initial Review letter in the mail which identifies the additional information needed.

If medical records are needed, providing the name of your health care provider(s) is not sufficient. You, or your doctor, must submit the needed medical records by the due date specified on the Initial Review letter. Medical records not timely submitted may result in your claim being denied.

After issuing an Initial Review letter, the Division has an additional 45 days to review the information received before issuing a Final Determination letter regarding compensability.

The Division will issue a Final Determination letter within 60 days of receiving your signed Report of Injury form. If benefits are denied, the letter will provide the reasons and inform you of your rights to a hearing if you disagree.

You must notify the Division, in writing, whenever you change your mailing address, physical address or telephone number. Failure to update the Division may result in benefit checks/or documents being mailed to the wrong address or delay payment of benefits.

A Claims Analyst assigned to manage your case is the person you should contact at the Division in order to obtain assistance, information and claim forms. All Claims Analysts have voice mail and every effort is made to return calls within 24 hours.

Your Claims Analyst cannot discuss your claim with any other party (except your employer) without authorization from you. If you want to authorize the Division to discuss your claim with anyone, other than yourself, download the Release of Information form, complete and mail to the Division.

Notify the Division immediately when you return to work in either a full-time or part-time capacity, with your pre-injury employer or with a new employer.

Notify the Division when your doctor discharges you from treatment or releases you to return to work in any capacity.

You should make and keep photocopies of all papers and documents pertaining to your Workers’ Compensation claim.