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Get the free EMPLOYER’S FIRST REPORT OF OCCUPATIONAL INJURY OR DISEASE (Form 8WC)

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This form is required to report any occupational injury or disease to the NH Department of Labor and the employer's insurance carrier, to be filed within specified time frames to avoid penalties.
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How to fill out EMPLOYER’S FIRST REPORT OF OCCUPATIONAL INJURY OR DISEASE (Form 8WC)

01
Obtain Form 8WC from the appropriate state agency or employer resources.
02
Fill out the employer's information section, including the company name, address, and contact details.
03
Provide the injured employee's information, including their name, address, and job title.
04
Describe the nature of the injury or disease, including details of the incident and how it occurred.
05
Include the date and time of the incident as well as the location where it took place.
06
If applicable, provide information about any witnesses to the incident.
07
Sign and date the form to certify that the information provided is accurate.
08
Submit the completed form to the relevant state authority and keep a copy for your records.

Who needs EMPLOYER’S FIRST REPORT OF OCCUPATIONAL INJURY OR DISEASE (Form 8WC)?

01
Employers who have employees that have suffered an occupational injury or disease.
02
Insurance companies managing workers' compensation claims.
03
State labor departments or regulatory agencies overseeing workplace safety.
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WC-1 First Report of Injury (FROI). As soon as you have been notified of a work-related injury, please fill out this form and submit it to EMPLOYERS. This form must be completed within 10 days from notice of an accident. Fatalities must be reported within 24 hours.
1. Ensure Immediate Medical Care Assess the Severity: Quickly assess the severity of the injury. Provide First Aid: If the injury is not life-threatening but still requires attention, ensure that the worker receives appropriate first aid on-site or is taken to a medical facility for treatment.
First Report of Injury Form The form must be completed in quadruplicate and distributed to the state workers' compensation board, employer-designated compensation payer, the ill or injured party's employer, and the patient's work-related injury chart.
If you cannot work because of a work-related injury or illness for more than three days, you are eligible for benefits to replace part of your lost wages. Benefits are determined by your Average Weekly Wage (AWW) but cannot exceed the maximum weekly benefit amount which is calculated annually.

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EMPLOYER’S FIRST REPORT OF OCCUPATIONAL INJURY OR DISEASE (Form 8WC) is a document that employers must complete when an employee is injured or becomes ill due to work-related causes. It serves as an official record of the incident and is used for reporting to workers' compensation authorities.
Employers who have employees that experience a work-related injury or illness are required to file the EMPLOYER’S FIRST REPORT OF OCCUPATIONAL INJURY OR DISEASE (Form 8WC).
To fill out the EMPLOYER’S FIRST REPORT OF OCCUPATIONAL INJURY OR DISEASE (Form 8WC), employers should provide accurate and detailed information about the employee, the nature of the injury or illness, the circumstances of the incident, and any medical treatment provided. It's critical to ensure all sections of the form are completed thoroughly.
The purpose of EMPLOYER’S FIRST REPORT OF OCCUPATIONAL INJURY OR DISEASE (Form 8WC) is to formally document an occupational injury or disease for the purposes of workers' compensation and to facilitate the claims process for injured employees.
The information that must be reported on the EMPLOYER’S FIRST REPORT OF OCCUPATIONAL INJURY OR DISEASE (Form 8WC) includes the employee's personal details, the date and time of the incident, a description of the injury or illness, witnesses, and actions taken by the employer following the incident including any medical treatment provided.
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