Get the free OCCUPATIONAL INJURY OR DISEASE (Form 8WC)

EMPLOYERS FIRST REPORT OF OCCUPATIONAL INJURY OR DISEASE (Form 8WC) Return to: NH DOL USE ONLY The State of New Hampshire, Department of Labor P.O. Box 2077, Concord, NH 033022077 (603) 2713176 FAX:

How to fill out occupational injury or disease

How to fill out occupational injury or disease?

1. Start by obtaining the necessary forms: To fill out an occupational injury or disease report, you will need the specific form provided by your employer or the relevant workers' compensation agency. This form is typically known as an incident report or an injury/disease report.
2. Provide personal information: Begin by entering your personal details, such as your full name, contact information, and employee identification number. This will help identify you as the person filing the report.
3. Describe the injury or disease: Clearly and accurately describe the nature of the injury or disease you have sustained. Include details such as where and when it occurred, the circumstances surrounding the incident, and any contributing factors.
4. Provide medical information: In this section, include information about any medical treatment you have received or are currently undergoing for your injury or disease. This may include visits to doctors, hospitals, or any prescribed medication.
5. Include witness statements: If there were witnesses to the incident, request their statements regarding what they saw or experienced. Include their contact information as well, so that they can be reached for further inquiries if necessary.
6. Attach any supporting documents: If you have any relevant documents, such as medical reports, test results, or photographs of the incident scene, it is important to include them with the form. These documents can help establish the severity and legitimacy of your injury or disease.
7. Sign and submit the form: Once you have completed all the required sections, ensure that you sign and date the form. This signifies your agreement to the information you have provided. Make a copy of the form for your own records and submit the original to the designated authority or your employer's HR department.

Who needs occupational injury or disease?

1. Employees: Any employee who sustains an injury or contracts a disease while on the job should fill out an occupational injury or disease report. This ensures that they receive the necessary medical treatment and compensation they are entitled to.
2. Employers: Employers are responsible for providing a safe work environment for their employees. They need occupational injury or disease reports to fulfill their legal and moral obligations towards their workforce, such as arranging medical assistance and improving workplace safety measures.
3. Workers' compensation agencies: Workers' compensation agencies rely on occupational injury or disease reports to assess the validity of claims and provide appropriate compensation to affected individuals. These reports help them determine the extent of the injury or disease, evaluate the impact on the individual's ability to work, and determine the appropriate benefits.

In conclusion, filling out an occupational injury or disease report involves providing personal and medical information, describing the incident, attaching relevant documents, obtaining witness statements, and signing the form. Both employees and employers need these reports to ensure the well-being and compensation of injured or affected individuals, while workers' compensation agencies rely on them to assess claims and provide appropriate benefits.

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What is occupational injury or disease?

Occupational injury or disease is a health condition or injury that occurs as a result of work or occupational activities.

Who is required to file occupational injury or disease?

Employers are required to file reports of occupational injury or disease on behalf of their employees.

How to fill out occupational injury or disease?

The employer must gather information about the injury or disease, complete the necessary forms, and submit them to the relevant authorities.

What is the purpose of occupational injury or disease?

The purpose of reporting occupational injury or disease is to track workplace safety and health, identify trends, and take corrective actions to prevent future incidents.

What information must be reported on occupational injury or disease?

Information such as the nature of the injury or disease, the date and time it occurred, the affected employee's name and contact information, and any medical treatment received must be reported.