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X12 148 — Report of Injury, Illness, or Incident

The 148 documents an injury, occupational illness or incident report sent to an insurer, Workers' Compensation board, or OSHA.

Purpose

The 148 (First Report of Injury — FROI / Subsequent Report of Injury — SROI) is the foundational Workers' Compensation reporting instrument in the US. It carries the employer, the injured employee, the date and location of the incident, the nature of the injury, the care received, and the disability status.

It is part of the IAIABC (International Association of Industrial Accident Boards and Commissions) Release 3 standard built on X12 (148, 837, 824, 277). Acknowledged by 997; a state like California or Texas may return an 824 if the report misses a required DWC field.

Envelope structure

The 148 travels within the three X12 envelope levels (ISA/IEA, GS/GE with functional group EI, and ST/SE). Didactic example in release 004010:

x12 example-148.x12 
ISA*00*          *00*          *ZZ*ACMEEMPLOYER  *ZZ*CADWC          *260514*1300*U*00401*000000148*0*P*>~
GS*EI*ACMEEMPLOYER*CADWC*20260514*1300*1*X*004010~
ST*148*0001~
BGN*00*FROI-2026-0042*20260514~
N1*EM*ACME MANUFACTURING*24*EIN-12-3456789~
N1*EY*WORKER COMP CARRIER*46*NAIC-67890~
NM1*EE*1*DOE*JOHN*A***34*SSN-LAST4-5678~
DMG*D8*19840712*M~
DTM*450*20260514~
N4*FREMONT*CA*94538*US~
III*BJ*FORKLIFT INCIDENT - SHELVING COLLAPSE~
LX*1~
REF*ZZ*BODY-PART-LOWER-BACK~
SE*11*0001~
GE*1*1~
IEA*1*000000148~

Common segments

  • Header — ST, BGN (00=FROI, 04=SROI), DTM*450 (incident date).
  • Parties — N1*EM (Employer), N1*EY (Insurance Carrier), NM1*EE (Employee).
  • Injury — III (Injury / Illness / Incident Information), DMG (employee), N4 (location).
  • Details — repeated LX loop: REF (body part, nature), MSG (free-text description).
  • Summary — SE.

Common pitfalls

  • Jurisdiction state: each state Workers' Comp board imposes its own IAIABC obligations (FROI events, jurisdiction code). A CA-rejected report is not on the same schema as a TX report.
  • FROI vs SROI: an initial FROI (BGN02=00) cannot be re-sent as-is — any update is a SROI (BGN02=04) with appropriate event code (UR, AP, EP, IP).
  • PHI and HIPAA: medical details in the 148 may be PHI if the carrier is under HIPAA BAA; encrypt in transit (AS2, SFTP with dedicated keys).

Documentation

The code 148 and the name Report of Injury, Illness, or Incident are public and listed on x12.org/products/transaction-sets. The complete structure of loops, qualifiers and code lists is distributed by DISA via the proprietary Implementation Guides (TR3). ediverse.io covers only public concepts, the envelope and didactic examples.