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WORKERS COMPENSATION FIRST REPORT OF INJURY OR ILLNESS EMPLOYER NAME ADDRESS INCL ZIP CARRIER/ADMINISTRATOR CLAIM NUMBER OSHA LOG NUMBER REPORT PURPOSE CODE JURISDICTION INSURED REPORT NUMBER EMPLOYER S LOCATION ADDRESS IF DIFFERENT INDUSTRY CODE LOCATION EMPLOYER FEIN PHONE CARRIER/CLAIMS ADMINISTRATOR CARRIER NAME ADDRESS PHONE POLICY PERIOD CLAIMS ADMINISTRATOR NAME ADDRESS PHONE NO TO CHECK IF APPROPRIATE SELF INSURANCE CARRIER FEIN POLICY/SELF-INSURED NUMBER ADMINISTRATOR FEIN EMPLOYEE/WA ...

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What is OSHA recordable vs reportable?

A recordable incident becomes a reportable incident when it meets two specific criteria: 1) it causes a fatality, or 2) it causes injuries that require in-patient hospitalization or that result in amputation or loss of an eye.

What type of injuries must be reported?

Severe Injury Reporting Employers must report any worker fatality within 8 hours and any amputation, loss of an eye, or hospitalization of a worker within 24 hours.

Which injuries that occur on site should be reported and recorded?

Employers must record all work-related injuries and illnesses that result in: death, loss of consciousness, medical treatment beyond first aid, days away from work, restriction of work or transfer to another job.

What injuries need to be reported?

When do I need to report an incident? accidents resulting in the death of any person. accidents resulting in specified injuries to workers. non-fatal accidents requiring hospital treatment to non-workers. dangerous occurrences.

What is the OSHA form for reporting injuries?

The OSHA Form 300 is a form for employers to record all reportable injuries and illnesses that occur in the workplace, where and when they occur, the nature of the case, the name and job title of the employee injured or made sick, and the number of days away from work or on restricted or light duty, if any.

Why do injuries need to be reported?

When an incident is reported quickly it allows the injured worker the opportunity to receive quick and proper treatment that may be needed. Sometimes an employee may believe they have a minor injury and decide not to report it or get the injury evaluated which may cause it to become worse.

What form is used to report injury?

Complete an Injury and Illness Incident Report (OSHA Form 301) or equivalent form for each injury or illness recorded on this form. If youre not sure whether a case is recordable, call your local OSHA office for help. Feel free to use two lines for a single case if you need to.

What injuries must be reported to OSHA?

All employers are required to notify OSHA when an employee is killed on the job or suffers a work-related hospitalization, amputation, or loss of an eye. A fatality must be reported within 8 hours. An in-patient hospitalization, amputation, or eye loss must be reported within 24 hours.

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What is OSHA recordable vs reportable?

What type of injuries must be reported?

Which injuries that occur on site should be reported and recorded?

What injuries need to be reported?

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Why do injuries need to be reported?

What form is used to report injury?

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What is OSHA recordable vs reportable?

What type of injuries must be reported?

Which injuries that occur on site should be reported and recorded?

What injuries need to be reported?

What is the OSHA form for reporting injuries?

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Why do injuries need to be reported?

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