Request a State Agency Account with IWIF
Thank you for your interest in creating a State Agency Account with us. Having an account will allow you to access our online eServices.
Please provide as much information as you can so we can get started:
*
1.
Requestor’s First & Last Name:
(Required.)
2.
Requestor’s Title:
*
3.
Maryland State Agency's Name:
(Required.)
*
4.
Account/Agency Number:
(Required.)
*
5.
Email Address:
(Required.)
*
6.
Phone Number:
(Required.)
7.
Comments:
(Please include any additional email addresses you would like notified of this request)
*
8.
Select the desired eServices access level for this account:
(Required.)
Report Only
:
- Report an injury online
- Access to Safety Center
Claim Management
:
- Report an injury online
- Query a reported injury or claim
- Run detailed reports & loss runs
- Access to Safety Center
*may require employer approval