Mississippi Code

Miss. Code Ann. § 71-3-67 (2026)

Reports of injuries

✓ current as of July 2026

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(1) Within ten (10) days after the fatal termination of any injury, the employer, if self-insured, or its carrier, shall file a report thereof with the commission on a form approved by the commission for this purpose.
In the event of an injury which shall cause loss of time in excess of the waiting period prescribed in Section 71-3-11, a report thereof shall be filed with the commission by the employer or carrier, on a form approved by the commission for this purpose, within ten (10) days after the prescribed waiting period has been satisfied.
Within ten (10) days after the employer or carrier knows, or reasonably should know, that an injury has resulted, or likely will result, in permanent disability or serious head or facial disfigurement, but which does not cause a loss of time in excess of the prescribed waiting period, a report thereof shall be filed with the commission on a form approved by the commission for this purpose.

(2) Injuries not otherwise provided for in this section, and for which only medical benefits are due, are not required to be reported to the commission. Records of such injuries shall be maintained by the employer, if self-insured, or its carrier, and shall contain the name and address of the employee, the date of the accident, the name and address of the employer, the nature of the injury, the number of days lost and the total medical expense. These records shall be made available to the commission upon request.
If an injury provided for in this subsection subsequently causes a loss of time in excess of the prescribed waiting period, or causes permanent disability or serious head or facial disfigurement, it shall be reported within ten (10) days thereafter on the form approved for such claims.
Any additional reports shall be sent to the commission in such time and in such manner as the commission may prescribe.

(3) Filing may be by mail, electronic means or other form of delivery reasonably calculated to accomplish receipt by the commission. Any such report required to be filed hereunder shall be considered filed on the date of mailing, if filing is by mail, and on the date the electronic equipment being used acknowledges receipt of the material, if filing is by electronic means. Otherwise, the date of filing shall be the date of receipt by the commission.

(4) Whenever an employer or carrier fails or refuses to file any report required by this section within the time prescribed, the commission may, in its discretion, and after giving the employer or carrier notice and an opportunity to show cause to the contrary, levy a penalty against such employer or carrier not to exceed One Hundred Dollars ($100.00). This penalty shall be payable to the Administrative Expense Fund provided for by this chapter, and if not voluntarily paid, may be collected by civil suit brought by the commission.
In addition to the above civil penalty, a sum not to exceed One Hundred Dollars ($100.00) may, in the discretion of an administrative judge or the commission, be added to any award which may be made as a result of any injury not timely reported hereunder.

Codes, 1942, § 6998-34; Laws, 1948, ch. 354, § 28; Laws, 1950, ch. 412, § 13; reenacted without change, Laws, 1982, ch. 473, § 34; reenacted without change, Laws, 1990, ch. 405, § 36; Laws, 1995, ch. 582, § 1, eff. 7/1/1995.

Notes of Decisions

Cited in 11 cases, 1995–2011 · leading case: Prentice v. Schindler Elevator Co., 13 So. 3d 1258 (Miss. 2009).

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Prentice v. Schindler Elevator Co., 13 So. 3d 1258 (Miss. 2009). · cites it 6× “Section 71-3-67 of the Mississippi Code requires a self-insured employer to report to the Mississippi Workers' Compensation Commission within ten days the occurrence of any injury that disables an employee for five days or more.”

Holbrook v. Albright Mobile Homes, Inc., 703 So. 2d 842 (Miss. 1997). · cites it 2× “Because Albright failed to timely report the incident as required by Miss. Code Ann. § 71-3-67 (1995), and because Albright may have misled the Holbrooks concerning the existence of workers' compensation coverage, we hold that there are genuine issues of material fact as to…”

Blailock v. O'BANNON, 795 So. 2d 533 (Miss. 2001). “The filing of a Notice of Injury Report with the WCC is required by Miss. Code Ann. § 71-3-67 (2000). However, the Notice does not ripen into a claim until the employee files a Petition to Controvert.”

Gallagher Bassett Servs., Inc. v. Malone, 30 So. 3d 301 (Miss. 2010). · cites it 2× “Miss.Code Ann. § 71-3-67 (Rev.2000). This form is commonly known as a "B-3" form.”

Rogers v. Hartford Accident & Indem. Co., 133 F.3d 309 (5th Cir. 1998). “Miss.Code Ann. § 71-3-67(1); Vardaman S. Dunn, Mississippi worker’s compensation.”

Goodman v. Coast Materials Co., 858 So. 2d 923 (Miss. Ct. App. 2003). “Miss.Code Ann. § 71-3-67 (Rev.2000). This "First Report of Injury" set out the same claim as in Goodman's suit, namely, that he was assaulted by one of his co-employees.”

Nicholson v. Int'l Paper Co., Inc., 51 So. 3d 995 (Miss. Ct. App. 2010). “Section 71-3-67 requires the employer, if self-insured, to file an injury report with the Commission within ten days (1) in the event of death following an injury, (2) an injury which causes loss of time in excess of five days, or (3) an injury that resulted or is likely to…”

Timmy Prentice v. Schindler Elevator Corp. (Miss. 2007). · cites it 3× “4 Within ten (10) days after the employer or carrier knows, or reasonably should know, that an injury has resulted, or likely will result, in permanent disability or serious head or facial disfigurement, but which does not cause a loss of time in excess of the prescribed waiting…”

Michael Holbrook v. Albright Mobile Homes Inc (Miss. 1995). · cites it 2× “Because Albright failed to timely report the incident as required by Miss. Code Ann. § 71-3-67 (1995), and because Albright may have misled the Holbrooks concerning the existence of workers' compensation coverage, we hold that there are genuine issues of material fact as to…”

Dustin Ray Rhodes vs Bamaco, Inc., 425 F. App'x 804 (11th Cir. 2011). “An employer is required under Mississippi law to file an injury report with the Commission within ten days of an injury that has caused an employee to miss more than five days of work, Miss.Code Ann. § 71-3-67, but “the failure of an employer to file notice, alone, is not…”

Wanda Blailock v. Shirley O'Bannon (Miss. 2000). “The filing of a Notice of Injury Report with the WCC is required by Miss. Code Ann. § 71-3-67 (2000). However, the Notice does not ripen into a claim until the employee files a Petition to Controvert.”

— Miss. Code Ann. § 71-3-67(1) — 2 cases

Prentice v. Schindler Elevator Co., 13 So. 3d 1258 (Miss. 2009). “Section 71-3-67 of the Mississippi Code requires a self-insured employer to report to the Mississippi Workers' Compensation Commission within ten days the occurrence of any injury that disables an employee for five days or more.”

Rogers v. Hartford Accident & Indem. Co., 133 F.3d 309 (5th Cir. 1998). “Miss.Code Ann. § 71-3-67(1); Vardaman S. Dunn, Mississippi worker’s compensation.”

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