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RECEIVED BY CLAIMSHANDLING ENTITY FIRST REPORT OF INJURY OR ILLNESS SENT TO DIVISION DATE DIVISION RECEIVED DATE FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS COMPENSATION For assistance
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How to fill out first report of injury

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How to fill out first report of injury

01
Gather all relevant information about the injury, such as the date, time, and location it occurred.
02
Identify the person who was injured and provide their personal information, including their name, contact details, and role/position in the company.
03
Explain the details of the injury and how it occurred, including any contributing factors or external circumstances.
04
Include any witnesses to the incident and their contact information.
05
Provide a description of the injuries sustained, including the body parts affected and the severity.
06
Attach any supporting documentation, such as medical reports or photographs of the injury.
07
Ensure that the report is completed accurately and truthfully.
08
Submit the report to the appropriate authority within the specified timeframe.
09
Retain a copy of the report for your records.

Who needs first report of injury?

01
Employers need the first report of injury to comply with legal requirements and to track workplace injuries.
02
Employees who have suffered work-related injuries need the first report of injury to initiate a workers' compensation claim.
03
Insurance companies may require the first report of injury to process claims.
04
Government agencies responsible for workplace safety and health may request the first report of injury for statistical purposes.
05
Legal representatives involved in workers' compensation cases may need the first report of injury as evidence.
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The first report of injury is a form used to report a workplace injury or illness.
Employers are required to file the first report of injury when an employee is injured on the job.
The first report of injury should be filled out completely and accurately, including details of the injury, when it occurred, and any medical treatment provided.
The purpose of the first report of injury is to document workplace injuries and illnesses, track trends, and ensure proper treatment and compensation for injured employees.
The first report of injury should include details of the injured employee, the nature of the injury, when and where it occurred, and any medical treatment provided.
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