Get State Of Alabama First Report Fillable

Filling out the State Of Alabama First Report is an essential step for employers to report injuries or occupational diseases to the appropriate authorities. This guide provides a comprehensive walkthrough of the necessary sections and fields, ensuring the form is completed accurately and efficiently.

Follow the steps to complete the First Report Fillable online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the claim reference in the designated fields, including the insured report number, filing office claim number, and OSHA log case number for proper tracking.
3. In the employer section, provide the business name, physical address, city, state, and zip code. Ensure to include the federal ID number for identification purposes.
4. If the location of the incident differs from the business address, complete the mailing address section, including city, state, and zip code.
5. Fill in the insurer and filing office information, including the name, federal ID number, and relevant address details.
6. Proceed to the employee section; enter the employee's first, middle, and last name along with any applicable suffix. Record the employee ID number and specify the type of identification used.
7. Input the personal details of the employee, such as phone number, date of birth, marital status, number of dependents, and employment start date.
8. Next, report the employee's injury details, including the date and time of injury, and whether the injury occurred on the employer’s premises.
9. Provide a detailed description of the incident, including activities leading up to the injury, as well as nature, part of body affected, and cause of injury codes.
10. Indicate the initial treatment, name of the treatment facility, and any relevant address details. Also, note whether the employee has returned to work and the respective date.
11. Finally, fill in the date prepared, preparer's name, title, and contact information to conclude the report.
12. Once all fields are completed, save changes to the document. You can then choose to download, print, or share the form as needed.

Complete your filing of the State Of Alabama First Report online to ensure compliance and effective communication.