Get Pa First Report - Aviation Workers' Compensation

Completing the PA First Report - Aviation Workers' Compensation online is a straightforward process that requires careful attention to detail. This guide will assist you in filling out each section of the form accurately to ensure proper reporting of an occupational injury or disease.

Follow the steps to accurately fill out the PA First Report online.

1. Click ‘Get Form’ button to access the report form and open it in your browser.
2. Begin by entering the employee's social security number in the designated field.
3. Fill in the date of injury by selecting the appropriate month, day, and year.
4. Provide the employee's first and last name, along with their street address, city, state, zip code, and county.
5. Indicate the employee’s gender and marital status, as well as the number of dependents.
6. Enter the employee's date of birth and their occupation or job title.
7. If known, include the NCCI class code, employment status (full-time, part-time, seasonal, volunteer, or other), and employer details including the employer's name and address.
8. Specify the employer's SIC code, FEIN, phone number, county, and NAICS code.
9. Indicate whether the employee received full pay for the day of injury and provide the time they started work.
10. Record the last day the employee worked and the time of the occurrence of the injury.
11. Enter the date the employer was notified of the injury, the date the disability began, and the date of hire.
12. Provide contact details for the person completing the report, including their name and phone number.
13. Select the type of injury code, part of body affected code, cause of injury code, and describe the type of injury or illness.
14. Indicate whether the injury or illness occurred on the employer's premises and whether safeguards or safety equipment were provided and used.
15. Detail all equipment, materials, or chemicals the employee was using when the accident occurred, and describe how the injury or illness happened.
16. Record the initial treatment details and, if applicable, the date of death for fatal accidents.
17. Provide information about the clinic or hospital, including the physician or health care provider's name.
18. Note the insurance policy period and the name of the insurance carrier or third-party administrator.
19. Complete the form by providing the witness details and the date prepared.
20. Once all fields are filled out, carefully review the information for accuracy before saving changes, downloading, printing, or sharing the form as needed.

Complete your documents online for a smooth and efficient reporting process.