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Agent Services Handbook 457 (717) www.dmv.pa.govTABLEOFCONTENTS I. Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Penndot Pub 457 is a form used by employers to report work-related injuries and illnesses to the Pennsylvania Department of Transportation (PennDOT).
Employers in Pennsylvania are required to file Penndot Pub 457 if an employee experiences a work-related injury or illness.
To fill out Penndot Pub 457, employers must provide details about the injured employee, the injury or illness, and the circumstances surrounding the incident.
The purpose of Penndot Pub 457 is to ensure that work-related injuries and illnesses are properly recorded and reported to PennDOT for tracking and analysis purposes.
Employers must report information such as the injured employee's name, date of birth, job title, date of injury, nature of injury, and any medical treatment received.
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