Workers Compensation Form For Employers
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If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.
We protect your documents and personal data by following strict security and privacy standards.
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FAQ
If a person working for you has a work-related injury or disease and gets medical treatment from a doctor or other qualified practitioner, as the employer, you must report the incident to us. We need to hear from you as soon as possible.
Employer's Report of Injury/Disease (Form 7) When your employer finds out about your injury, they must file a Form 7 with the Board within 3 business days. The information your employer puts on this form is important because it affects the amount of money you might get in benefits.
To be considered valid, a completed Form 7 must be authorized by the employer or a representative of the employer (e.g., a bookkeeper, safety representative, or an accountant). Sole proprietors and independent operators who have obtained optional insurance may authorize a report of their own accident.
In those instances, employees must complete Form 67 ? Workplace Health, Safety and Compensation ? Report of Accident or Industrial Disease. Contact Information. Name of person(s) involved in the accident.
Generally, registration is mandatory if you are an employer: Conducting business in a mandatory industry (e.g., hotels, restaurants, supermarkets, fishing, trucking, construction and other manufacturing.) and you have three or more workers at one time.
