Get Supervisor's/agency - "report Of Injury" - Cuny - Cuny

Filling out the Supervisor's/Agency 'Report of Injury' form is an important step in documenting workplace injuries. This guide provides clear instructions to help you complete the form accurately and effectively, ensuring compliance with reporting requirements.

Follow the steps to efficiently complete the form.

1. Click the ‘Get Form’ button to access the report. This will allow you to open the form in the editor for completion.
2. Begin by entering the claim number at the top of the form. If available, include the employee ID to assist with identification.
3. Fill in the injured employee's details, including their full name, address, and the date and time of the accident or injury.
4. Indicate whether the employee is expected to return to work and whether they were absent due to the injury. Provide specific information regarding any notice of injury given by the employee.
5. Complete the section regarding the accident location, including if it occurred on the employer's premises and if it involved traveling between work sites.
6. Detail the circumstances of the injury, including whether it was witnessed, a description of the injury, and any pre-existing conditions that may be relevant.
7. Provide information on the medical treatment received by the employee, including the type of facility and the nature of the treatment.
8. Fill out any additional information needed, such as whether an object was involved in the injury and the nature of the accident.
9. Review all sections for completeness and accuracy. Ensure that all relevant attachments, if required, are included.
10. Once you have filled out the entire form, save your changes. You can then download, print, or share the completed form as needed.

Complete your documents online to ensure timely processing and compliance.