Get the free Workers Compensation First Report of Injury or Illness - grinnell

Grinned College Workers Compensation First Report of Injury or Illness Return as an email attachment to hr grinned.edu or fax to 6412694885 (send original via campus mail to HR in the Old Glove Factory)

How to fill out workers compensation first report

How to fill out workers compensation first report

1. First, gather all necessary information about the incident, such as date, time, and location.
2. Next, identify the injured employee and gather their personal information, including name, contact details, and job title.
3. Provide a detailed description of the incident, including how and where it occurred, and the nature of the injury or illness.
4. Document any witnesses or individuals involved in the incident, noting their contact information.
5. Include relevant medical information, such as the initial diagnosis, treatment received, and any ongoing care plans.
6. Fill in the employer information, including company name, address, and contact details.
7. Complete the insurance information section, providing the details of the workers' compensation insurance carrier.
8. Include any supporting documents or evidence related to the incident, such as photographs, incident reports, or surveillance footage.
9. Once all the necessary information has been collected, review the report for accuracy and completeness.
10. Submit the completed workers' compensation first report to the appropriate authority or insurance company as required.

Who needs workers compensation first report?

1. Employers who have employees are typically required to fill out a workers' compensation first report.
2. Employees who have suffered a work-related injury or illness may also need to report it to their employer.

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