Get the free Kentucky work comp first report of injury fillable form - murraystate
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WORKERS COMPENSATION FIRST REPORT OF INJURY OR ILLNESS EMPLOYER (NAME & ADDRESS INCL ZIP) CARRIER/ADMINISTRATOR CLAIM NUMBER Murray State University Human Resources 404 Sparks Hall Murray, KY 42071-3312
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How to fill out kentucky work comp first
How to fill out Kentucky work comp first:
01
Obtain the necessary forms from your employer or the Kentucky Department of Workers' Claims.
02
Carefully read through the instructions provided with the forms to understand the information required and any specific guidelines.
03
Begin by providing your personal information, such as your name, address, and contact details.
04
Provide details about your employer, such as their name, address, and contact information.
05
Indicate the date and time of your work-related injury or illness.
06
Describe the nature of your injury or illness and how it occurred. Include any relevant details, such as the location, equipment involved, and other contributing factors.
07
If you sought medical treatment, provide information about the healthcare provider, facility, and any diagnosis or treatment given.
08
Provide details about your employment, such as your job title, duties, and hourly wage or salary.
09
Include information about any witnesses to the incident or anyone who can verify your injury or illness.
10
Sign and date the form, and submit it according to the instructions provided.
Who needs Kentucky work comp first:
01
Any employee who sustains a work-related injury or illness in the state of Kentucky is required to fill out the Kentucky work comp first form.
02
This includes both full-time and part-time employees, as well as temporary and seasonal workers.
03
Employers are also responsible for ensuring that their employees fill out this form in a timely manner, as part of the workers' compensation process.
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What is kentucky work comp first?
Kentucky work comp first refers to the initial report that must be filed with the Kentucky Workers' Compensation Board when a work-related injury or illness occurs.
Who is required to file kentucky work comp first?
Employers in Kentucky are required to file kentucky work comp first when a work-related injury or illness occurs.
How to fill out kentucky work comp first?
Kentucky work comp first can be filled out online through the Kentucky Workers' Compensation Board's website. Employers need to provide information about the injured employee, the nature of the injury or illness, and other relevant details.
What is the purpose of kentucky work comp first?
The purpose of kentucky work comp first is to ensure that employers promptly report work-related injuries or illnesses to the Workers' Compensation Board, allowing for appropriate recording, investigation, and processing of the claim.
What information must be reported on kentucky work comp first?
Kentucky work comp first requires employers to report information such as the name of the injured employee, the date and location of the injury or illness, a description of the nature of the injury or illness, and the medical treatment provided, among other relevant details.
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