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Click ‘Get Form’ to open the Missouri Report Injury Form in our platform's editor.
Begin by filling out the EMPLOYEE INFORMATION section. Enter the date of the incident, employee number, and campus location. Provide your full name, home address, phone number, and supervisor's details.
In the ACCIDENT INFORMATION section, specify the date the university was notified and indicate if salary will continue. Describe the incident type and body part affected. Include a brief description of the injury and detail any equipment used at the time.
Complete the MEDICAL TREATMENT section by indicating whether medical treatment was received. If applicable, provide details about the treating physician or clinic.
Finally, ensure that your supervisor signs or types their name before submitting the form using our platform’s submit button.
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What are examples of protected activity under section 7?
Examples include: talking with one or more co-workers about your wages and benefits or other working conditions, circulating a petition asking for better hours, participating in a concerted refusal to work in unsafe conditions, openly talking about your pay and benefits, and joining with co-workers to talk directly to
What not to say to Workmans Comp?
What Not to Say to a Workers Comp Doctor Avoid Downplaying Your Injury: Dont minimize your pain or discomfort. Dont Speculate on Recovery Time: Do not make guesses about how quickly you will recover. Stay Away from Absolute Statements: Do not use words like always or never when describing your symptoms.
What form is filed when an injury occurs?
You may use OSHAs 301: Injury and Illness Incident Report or an equivalent form. Some state workers compensation, insurance, or other reports may be acceptable substitutes, as long as they provide the same information as the OSHA 301. 1.
What is a DWC 7 form in California?
Workers Compensation Claim Form (DWC-7) Form DWC-7 is a notice to provide injured workers with rights, benefits and contact information.
How long do you have to report an injury in Missouri?
An employer or its insurer must report the injury, other than an injury that requires immediate first aid and no further medical treatment or lost time from work, to the Division of Workers Compensation within 30 days after knowledge of the injury.
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People also ask
What is the DWC 7 form?
Form DWC-7 is a notice to provide injured workers with rights, benefits and contact information. DOWNLOAD DWC-7 FORM.
Related links
Report of Injury
Report of Injury. Th s f m should b com l t d o all mplo e s Form button. You may also fax the completed form to (573-882-7861), or
Report Your Injury | Missouri Department of Labor and
You can use this online form if your employer does not provide you with a form. Always make a copy of the written notice for yourself and keep a written record
A: File this report if all of the following are true: The accident happened in Missouri. The accident happened within the last 12 months. Someone involved in
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