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COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT DIVISION OF WORKERS COMPENSATION See instructions on reverse side before completing form. EMPLOYERS FIRST REPORT OF INJURY Employees name (first, middle,

How to fill out first report of injury

How to fill out the first report of injury:

1. Obtain the necessary forms: Start by obtaining the first report of injury form from your employer or workers' compensation provider. This form is typically available in hard copy or online.
2. Gather information: Before filling out the form, gather all the necessary information. This includes the injured employee's personal details (name, address, contact number), employment information (job title, department), and the details of the injury (date, time, location, cause).
3. Describe the injury: In the report, provide a detailed description of the injury. Include information about how it occurred, any contributing factors, and the severity of the injury. Be as specific as possible to ensure an accurate record.
4. Report witnesses: If there were any witnesses to the incident, include their names and contact information in the report. Their testimonies can provide crucial support for the injury claim.
5. Include medical treatment: If the employee sought medical treatment for the injury, note the healthcare provider's details, such as their name, clinic, and contact information. Additionally, provide details about any medical diagnoses, treatment received, and recommended follow-up care.
6. Submit the report: Once the form is completed, submit it to the appropriate person or department. This is typically the employer's human resources department or the workers' compensation provider.

Who needs the first report of injury?

1. Employers: Employers need the first report of injury as it serves as an official document to document and report workplace injuries to ensure compliance with legal and regulatory requirements.
2. Injured employees: Injured employees need to complete the first report of injury to initiate the workers' compensation claim process. Filling out this report helps ensure that their injury is properly documented and allows them to seek compensation for medical expenses and lost wages.
3. Workers' compensation providers: Workers' compensation providers require the first report of injury to assess the claim's validity and determine appropriate benefits for the injured employee. This form helps them establish the necessary paperwork and documentation for processing the claim.

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What is first report of injury?

The first report of injury is a document that details information about an injury that occurred in the workplace.

Who is required to file first report of injury?

Employers or their insurance carriers are required to file the first report of injury.

How to fill out first report of injury?

The first report of injury should be filled out with details about the injured employee, the nature of the injury, and how it occurred.

What is the purpose of first report of injury?

The purpose of the first report of injury is to document workplace injuries for record-keeping and insurance purposes.

What information must be reported on first report of injury?

Information such as the employee's name, date of injury, description of the injury, and whether medical treatment was required must be reported on the first report of injury.