Get the free First Report of Injury - West Virginia Insurance Commission - wvinsurance
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STATE OF WEST VIRGINIA O STATE AGENCY A WORKERS' COME SENSATION PROGRAM Send Co completed FO ORM To: Zurich Insurance NCE PO Box 968053 O Charm burg, IL 60 0196-8053 FAX 215-861X: -6893 West Virginia
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What is first report of injury?
The first report of injury is a document that records and documents the details of an employee's work-related injury or illness.
Who is required to file first report of injury?
Employers are typically required to file the first report of injury on behalf of their employees.
How to fill out first report of injury?
The first report of injury form typically requires information such as the employee's name, date of injury, a description of the injury, and any medical treatments received. The form should be filled out accurately and promptly.
What is the purpose of first report of injury?
The purpose of the first report of injury is to provide documentation of work-related injuries or illnesses, track trends in workplace incidents, and facilitate the management of workers' compensation claims.
What information must be reported on first report of injury?
The first report of injury usually requires information such as the employee's name, date of birth, social security number, date and time of the injury, location of the incident, nature of the injury, witness information, and other relevant details.
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