Get the free Employer's First Report of Injury or Occupational Disease

This document is a report that employers in Georgia must submit regarding any employee's injury or occupational disease, including details about the employee, the incident, and the nature of the injury.

How to fill out employers first report of

How to fill out Employer's First Report of Injury or Occupational Disease

1. Obtain the Employer's First Report of Injury or Occupational Disease form from your state's workers' compensation website or your HR department.
2. Fill in the employer's name, address, and contact information at the top of the form.
3. Provide the employee's name, address, and social security number.
4. Include details about the injury or occupational disease, including date and time of the incident.
5. Describe how the injury occurred or the nature of the occupational disease.
6. Indicate whether the employee was performing work-related duties at the time of the incident.
7. Record any medical treatment the employee has received or may need.
8. Sign and date the form, ensuring that all information provided is accurate.
9. Submit the form to your state’s workers' compensation board as well as provide a copy to the employee.

Who needs Employer's First Report of Injury or Occupational Disease?

1. Employers who have employees that experience work-related injuries or occupational diseases.
2. Employees who are injured or become ill due to work are required to have this report filed for their workers' compensation claims.

For pdfFiller’s FAQs

What is Employer's First Report of Injury or Occupational Disease?

The Employer's First Report of Injury or Occupational Disease is a formal document submitted by an employer to report an employee's work-related injury or occupational disease to the appropriate workers' compensation authorities.

Who is required to file Employer's First Report of Injury or Occupational Disease?

Employers are typically required to file the Employer's First Report of Injury or Occupational Disease when their employee sustains an injury or develops an occupational illness that is work-related.

How to fill out Employer's First Report of Injury or Occupational Disease?

To fill out the report, employers need to provide accurate details about the injured employee, the nature and circumstances of the injury or illness, and any relevant medical information and witness accounts.

What is the purpose of Employer's First Report of Injury or Occupational Disease?

The purpose of the report is to formally notify workers' compensation authorities about an injury or occupational disease claim, initiate the claims process, and ensure that the employee receives proper care and compensation.

What information must be reported on Employer's First Report of Injury or Occupational Disease?

The report must include information such as the employee's personal details, description of the injury or disease, date and time of the incident, place of occurrence, details about witnesses, and any prior medical history related to the injury.