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Pinnacol first report of injury form 2009-2025

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4.3 out of 5

52 votes

The document is a 'First Report of Injury' form used to report work-related injuries to Pinnacol Assurance. It provides detailed instructions for employers on how to report claims, including necessary information about the injured worker, accident details, and medical treatment. The form emphasizes the importance of early reporting within 24 hours to reduce costs and facilitate quicker recovery for the employee. It also includes guidelines for compliance with Colorado Workers' Compensation Act and OSHA recordkeeping requirements.

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2015	4.8 Satisfied (146 Votes)
2009	4.3 Satisfied (52 Votes)

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What is a first report of injury?

The Employers First Report of Injury or Illness provides information on the claimant, employer, insurance carrier and medical practitioner necessary to begin the claims process. Details of the claimants employment and circumstances surrounding the injury or illness are also requested.

How soon after an injury occurs should you fill out an injury report?

Make sure your supervisor is notified of your injury as soon as possible. If your injury or illness developed gradually, report it as soon as you learn or believe it was caused by your job. Reporting promptly helps avoid problems and delays in receiving benefits, including medical care.

How long does an employee have to report an injury in Colorado?

Within 10 working days of the injury, the injured worker must let their employer know about the injury. This must be done in writing. If the worker was injured more than 10 days ago, they should still notify their employer in writing as soon as possible.

What is the first report of injury in Colorado?

First Report of Injury/Notice of Contests When a worker is injured or has an occupational disease that results in more than three days/shifts of lost time, permanent impairment, or death, the insurance carrier must file a First Report of Injury (FROI) with the Division of Workers Compensation (DOWC) within 10 days.

What is the first report of injury form in Colorado?

Form WC 1 Employers First Report of Injury. All injuries or occupational diseases that result in lost time from work in excess of three shifts or calendar days or from permanent physical impairment must be reported to EMPLOYERS on this form within 10 days after notice or knowledge of the injury or disease.