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Incident Investigation First Report of Injury - CAPS Payroll 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by filling out the Injured Worker Information section. Enter the worker's name, Social Security number, address, and contact details. Ensure accuracy as this information is crucial for processing.
- Next, complete the Date of Injury and Time of Injury fields. This information should be recorded as soon as possible after the incident.
- In the Medical Provider Information section, provide details about the treating clinic or hospital. Indicate whether an ambulance was called and if additional treatment is required.
- Fill out the Accident Location section with precise details about where the incident occurred, including weather conditions and witness information.
- Injury Investigation requires a detailed description of how the injury occurred. Be thorough in documenting nature of injury and any direct causes.
- Finally, complete the Person Completing Form section with your name, title, phone number, signature, and date to validate the report.
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