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APPENDIX 18 rev c EMPLOYEE INJURY or NEAR MISS REPORT The Division will process this information with Workers Compensation Board on behalf of the employee. Part 1: To be completed by Employee and/or

How to fill out employee incidentinjury report appendix

How to fill out employee incident/injury report appendix:

1. Obtain the employee incident/injury report appendix form from your employer or human resources department.
2. Fill out the personal information section, including your name, employee ID, and contact details.
3. Provide a clear and concise description of the incident or injury in the dedicated section. Include details such as date, time, location, and any contributing factors.
4. Indicate the type of injury or incident that occurred, whether it is work-related or non-work-related.
5. Include information about any medical treatment received, including the name of the healthcare provider and the date/time of treatment.
6. Document any witnesses to the incident/injury and their contact information if applicable.
7. Provide additional details or notes that may be relevant to the incident/injury.
8. Review the completed employee incident/injury report appendix for accuracy and ensure all necessary information is included.
9. Sign and date the form, acknowledging that the information provided is true and accurate to the best of your knowledge.

Who needs employee incident/injury report appendix?

1. Employees who have experienced a work-related incident or injury that requires documentation.
2. Employers and human resources departments who need to maintain accurate records of employee incidents and injuries.
3. Insurance companies and legal professionals who may require the incident/injury report appendix for claims or legal purposes.

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What is employee incidentinjury report appendix?

The employee incident/injury report appendix is a document used to report any accidents or injuries that occur in the workplace.

Who is required to file employee incidentinjury report appendix?

Employers are required to file the employee incident/injury report appendix when an accident or injury occurs in the workplace.

How to fill out employee incidentinjury report appendix?

The employee incident/injury report appendix should be filled out with details of the accident or injury, including the date, time, location, and description of what happened.

What is the purpose of employee incidentinjury report appendix?

The purpose of the employee incident/injury report appendix is to document workplace accidents or injuries and ensure that proper steps are taken to prevent them from happening again.

What information must be reported on employee incidentinjury report appendix?

The employee incident/injury report appendix must include details such as the name of the employee involved, the nature of the injury, and any witnesses to the incident.