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First Report Adjuster Date Stamp of Injury and Occupational Disease Montana Department of Labor and Industry PO Box 8011 Helena, MT 596048011 Worker Last Name First Name M.I. Date of Birth Social
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What is of Injury and Occupational Disease Form?

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Injury and occupational refers to any injury or illness that occurs in the workplace.
Employers are required to file reports of injury and occupational to the relevant authorities.
Employers can fill out reports of injury and occupational online or submit physical forms to the appropriate agencies.
The purpose of reporting injury and occupational is to ensure the safety and well-being of employees and to track workplace incidents.
Information such as the date, time, location, nature of the injury or illness, and details of the affected employee must be included in reports of injury and occupational.
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