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FIRST REPORT OF INJURY CLAIMS DIVISION SON 2828 (11/2017)1600 E Century Ave, Ste 1 PO Box 5585 Bismarck ND 585065585 Telephone 8007775033 Toll Free Fax 8887868695 TTY (hearing impaired) 8003666888

How to fill out first report of injury

How to fill out first report of injury

1. To fill out the first report of injury, follow these steps:
2. Obtain the necessary forms: Typically, your employer or human resources department will provide you with the first report of injury form. If you cannot locate it, ask the appropriate person for a copy.
3. Gather all relevant information: Make sure to collect accurate details about the injured person, including their name, contact information, job title, and department. Additionally, note the date, time, and location of the injury.
4. Describe the injury: Provide a detailed account of how the injury occurred, including any contributing factors or hazards present. Be factual and concise while documenting the nature of the injury. If possible, include any witnesses or colleagues who were present at the time.
5. Include medical information: If the injured person sought medical treatment, specify the healthcare provider's name, address, and contact details. Additionally, provide a summary of the diagnosis, treatment, and any prescribed medications.
6. Report any time off work: Indicate whether the injured person will require any time off work due to their injury. Include the dates they will be absent and any anticipated return-to-work plans.
7. Submit the form: Once you have completed the first report of injury form, submit it to the designated person or department within your organization. Keep a copy for your records.

Who needs first report of injury?

1. The first report of injury is typically required by both employees and employers. Employees who have sustained a work-related injury or illness need to complete this report to initiate the compensation process and ensure proper documentation. Employers require this report to fulfill reporting obligations to insurance providers and government agencies, as well as to assess workplace safety and implement preventive measures.

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What is first report of injury?

The first report of injury is a form used to report details about a workplace injury or illness.

Who is required to file first report of injury?

Employers are required to file the first report of injury when an employee is injured on the job.

How to fill out first report of injury?

The first report of injury can be filled out by providing details about the incident, the employee, and the injuries sustained.

What is the purpose of first report of injury?

The purpose of the first report of injury is to document workplace injuries, provide information for insurance claims, and track safety trends.

What information must be reported on first report of injury?

Information such as the date, time, and location of the incident, the nature of the injury, and any treatment received must be reported on the first report of injury.