Get the free Supervisor’s Follow-Up Report of Occupational Injury or Illness - somervillema

This form is to be completed by the supervisor of an injured employee, detailing the circumstances and follow-up regarding an occupational injury or illness in the City of Somerville.

How to fill out supervisors follow-up report of

How to fill out Supervisor’s Follow-Up Report of Occupational Injury or Illness

1. Begin by entering the date of the injury or illness at the top of the report.
2. Fill in the name of the employee involved in the incident.
3. Provide a detailed description of the incident, including the circumstances surrounding the injury or illness.
4. Include any immediate actions taken in response to the incident.
5. Document any medical treatment provided, including the name of the healthcare provider if applicable.
6. Note any time missed from work due to the injury or illness.
7. Indicate any changes made to prevent future incidents, such as training or safety measures.
8. Sign and date the report to confirm its accuracy before submission.

Who needs Supervisor’s Follow-Up Report of Occupational Injury or Illness?

1. Supervisors require the Supervisor’s Follow-Up Report to document workplace incidents.
2. Human Resources may need it to evaluate workers' compensation claims.
3. Management uses it to analyze safety performance and implement preventive measures.
4. The injured employee may need the report for their personal records or medical follow-up.

For pdfFiller’s FAQs

What is Supervisor’s Follow-Up Report of Occupational Injury or Illness?

The Supervisor’s Follow-Up Report of Occupational Injury or Illness is a document used to provide detailed information about an employee's injury or illness that occurred at work, ensuring proper follow-up and management of the case.

Who is required to file Supervisor’s Follow-Up Report of Occupational Injury or Illness?

Supervisors or managers responsible for overseeing the injured employee's work are required to file the Supervisor’s Follow-Up Report of Occupational Injury or Illness.

How to fill out Supervisor’s Follow-Up Report of Occupational Injury or Illness?

To fill out the Supervisor’s Follow-Up Report, gather all necessary information about the incident, including the date, time, location, and nature of the injury or illness, as well as any witnesses and actions taken following the incident. Complete the form accurately and submit it to the appropriate department.

What is the purpose of Supervisor’s Follow-Up Report of Occupational Injury or Illness?

The purpose of the Supervisor’s Follow-Up Report is to document the incident, track the recovery process, ensure compliance with occupational safety regulations, and facilitate any necessary medical care or follow-up actions.

What information must be reported on Supervisor’s Follow-Up Report of Occupational Injury or Illness?

The report must include information such as employee details, date and time of the incident, a description of the injury or illness, actions taken in response, any medical treatment provided, and any recommendations for preventing future incidents.