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You or your employer may file a Workers' Compensation-First Report of Injury of Illness form to file with the Commission. This form should be filed within ten (10) days of the employer receiving notice of the injury or accident.

Medical benefits are paid regardless of the number of days missed from work. If the injured worker suffers fewer than 14 days of disability (days on which the worker is unable due to injury to earn his regular wage) as the result of a job related injury, wage loss payments are not made for the first 5 days.

Compensation is 66 2/3 percent of the injured workers wage. Minimum weekly payment is $25. Maximum weekly payment is 66 2/3 percent of the Mississippi state average weekly wage, $398.93. Maximum number of payments is limited to 450 weeks.

Under the Mississippi Workers' Compensation Act, following a work related injury, a claimant has two years to file a claim for benefits.

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FORM MS-10 is used for this purpose and must be filed even if no workers' compensation premium was written in Mississippi during the calendar year. WC7684 – Early notification of severe injury.A means of finalizing a Mississippi workers' compensation claim is to file a "Notice of. Final Payment" (Form B-31) with the Commission. These forms are to be completed and filed on all claims. ITEMS 1 - 17 — Prehearing Statement Of Claimant Or Employer-Carrier Form. This is a Mississippi form and can be use in Workers Compensation.

Mississippi Workers' Compensation Forms

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