skip to Main Content

First Benefits Insurance Mutual Claims

Claims Department Phone: 800.360.7867
Fax: 919.977.5844

It is important for an employer to complete a First Report of Injury or Illness and submit it to First Benefits within 24 hours of injury so that we can provide appropriate forms to an employee on your behalf.

If an employee misses time from work due to a compensable injury, he or she will be entitled to wage replacement benefits called temporary total disability.  In order to determine the amount of weekly compensation an injured worker is entitled to receive, we need for you to complete a Wage Chart Form (VWC Form No. 7A).  The Wage Chart Form should reflect gross wages earned by the injured worker during the 52-weeks immediately preceding the date of injury.  There are specific instructions on how to complete a Wage Chart Form on the second page of the attachment.

Questions? Contact us at or call (800) 360-7867.

Back To Top