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UNIVERSITY OF ILLINOIS FIRST REPORT OF INJURY/ILLNESS Submit via campus mail or electronically to Worktop Illinois.edu (To be completed within 24 hours of incident by employee) EMPLOYEE INFORMATION

How to fill out first report of injuryillness

How to fill out first report of injury/illness:

1. Gather all necessary information: Before starting the report, make sure to collect all the relevant details related to the injury or illness. This may include the employee's name, job title, date and time of the incident, location, witness statements (if any), the nature of the injury/illness, and any contributing factors.
2. Begin with employee details: On the report form, start by entering the employee's full name, contact information, job title, and department. This information will help identify the person involved and ensure accurate record-keeping.
3. Provide incident details: On the report form, clearly describe the incident that occurred. Include the date, time, and location of the accident or when the employee first became aware of the illness. Provide a detailed account of what happened, including any contributing factors or potential hazards.
4. Describe the injury/illness: Explain the type and severity of the injury or illness in detail. Use specific terms to accurately describe the affected body part(s) or symptoms and state whether the condition is work-related or not. If applicable, indicate whether medical treatment was sought and document any medical diagnoses or recommendations.
5. Include witness statements: If there were witnesses to the incident, ask them to provide a statement detailing what they saw or heard. Their accounts can help provide additional evidence and support for the report.
6. Report any unsafe conditions: If the incident was caused by unsafe conditions or equipment, make sure to note this in the report. Describe the hazardous conditions or malfunctioning equipment that contributed to the injury or illness.
7. Attach supporting documentation: If there are any relevant documents or photographs that support the incident report, attach them to the form. This could include medical reports, incident photographs, or any other evidence that helps to clarify the situation.
8. Review and sign: Before submitting the report, review it for accuracy, completeness, and clarity. Check for any spelling or grammatical errors, and make sure all required fields have been filled out. Once reviewed, sign and date the report before forwarding it to the appropriate department or supervisor.

Who needs first report of injury/illness?

1. Employers: The first report of injury/illness is essential for employers to maintain proper records of incidents that occur in the workplace. It helps them track trends, identify hazards, and implement corrective measures to prevent future accidents.
2. Employees: The first report of injury/illness is important for employees to ensure that their injuries or illnesses are documented and addressed appropriately. It helps them access necessary medical treatment and file any related insurance claims.
3. Insurance providers: Insurance companies require the first report of injury/illness to process claims accurately. The report helps them determine the cause, extent, and legitimacy of the injury or illness, enabling them to provide appropriate compensation or coverage.
4. Regulatory agencies: Government regulatory agencies, such as occupational health and safety bodies, may require the first report of injury/illness to ensure that employers are meeting their legal obligations to provide a safe working environment. These agencies use the reports to monitor workplace safety and enforce compliance with regulations.

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