Get the free Get the free FIRST REPORT OF INJURY SBS To report a claim call your

Get Form

Show details

FIRST REPORT OF INJURY To report a claim: Call 3033614000 or 18008737242 Or Fax to 3033615000 or 18883292251 Or, go to www.pinnacol.com PLEASE PRINT CLEARLYPINNACOL ASSURANCEEarly reporting can save

We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign first report of injury

Edit your first report of injury form online

Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.

Add your legally-binding signature

Draw or type your signature, upload a signature image, or capture it with your digital camera.

Share your form instantly

Email, fax, or share your first report of injury form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing first report of injury online

Ease of Setup

pdfFiller User Ratings on G2

Ease of Use

pdfFiller User Ratings on G2

Follow the steps down below to take advantage of the professional PDF editor:

1

Log in to your account. Start Free Trial and sign up a profile if you don't have one.

2

Prepare a file. Use the Add New button to start a new project. Then, using your device, upload your file to the system by importing it from internal mail, the cloud, or adding its URL.

3

Edit first report of injury. Rearrange and rotate pages, insert new and alter existing texts, add new objects, and take advantage of other helpful tools. Click Done to apply changes and return to your Dashboard. Go to the Documents tab to access merging, splitting, locking, or unlocking functions.

4

Save your file. Select it from your list of records. Then, move your cursor to the right toolbar and choose one of the exporting options. You can save it in multiple formats, download it as a PDF, send it by email, or store it in the cloud, among other things.

It's easier to work with documents with pdfFiller than you could have ever thought. You can sign up for an account to see for yourself.

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.

Learn more about security & compliance

How to fill out first report of injury

01

Gather information about the injured person's name, contact details, job title, and department.

02

Note down the date, time, and location of the incident.

03

Describe in detail how the injury occurred and what body parts were affected.

04

Include information about any witnesses to the incident.

05

Document the initial medical treatment given to the injured person.

06

Provide additional notes or comments relevant to the injury.

07

Submit the completed first report of injury to the appropriate authority or department.

Who needs first report of injury?

01

Employers

02

Supervisors

03

Human resources personnel

04

Insurance providers

05

Legal representatives

Fill form : Try Risk Free

Rate the form

4.3

Satisfied

42 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

How do I modify my first report of injury in Gmail?

You may use pdfFiller's Gmail add-on to change, fill out, and eSign your first report of injury as well as other documents directly in your inbox by using the pdfFiller add-on for Gmail. pdfFiller for Gmail may be found on the Google Workspace Marketplace. Use the time you would have spent dealing with your papers and eSignatures for more vital tasks instead.

How do I edit first report of injury online?

The editing procedure is simple with pdfFiller. Open your first report of injury in the editor, which is quite user-friendly. You may use it to blackout, redact, write, and erase text, add photos, draw arrows and lines, set sticky notes and text boxes, and much more.

Can I sign the first report of injury electronically in Chrome?

Yes, you can. With pdfFiller, you not only get a feature-rich PDF editor and fillable form builder but a powerful e-signature solution that you can add directly to your Chrome browser. Using our extension, you can create your legally-binding eSignature by typing, drawing, or capturing a photo of your signature using your webcam. Choose whichever method you prefer and eSign your first report of injury in minutes.

What is first report of injury?

The first report of injury is an official document submitted to report an employee's work-related injury or illness. It serves as the initial notification to the relevant authorities and the employer regarding the circumstances of the incident.

Who is required to file first report of injury?

Typically, the employer or a designated representative is responsible for filing the first report of injury. In some cases, the employee may also file it.

How to fill out first report of injury?

To fill out the first report of injury, complete the required fields including employee details, information about the incident, descriptions of the injury, and any medical treatment provided. Ensure all sections are accurate and legible.

What is the purpose of first report of injury?

The purpose of the first report of injury is to document the injury or illness, facilitate the processing of workers' compensation claims, and ensure compliance with safety regulations and protocols.

What information must be reported on first report of injury?

Information required typically includes the employee's name and contact details, date and time of the injury, location of the incident, a description of how the injury occurred, and details of any witnesses.

Fill out your first report of injury online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now