Get First Report Of Injury Or Illness - Creative Risk Solutions

Filling out the First Report of Injury or Illness is an essential step in documenting incidents in the workplace. This guide will help you navigate the process smoothly and ensure that all relevant information is accurately reported.

Follow the steps to complete the form efficiently.

1. Click ‘Get Form’ button to access the online form and open it in the editor.
2. Begin by entering the 'Received By Claims-Handling Entity' and the relevant dates in the appropriate fields.
3. In the 'Employee Information' section, provide the employee's full name, social security number, date and time of the accident, home address, contact number, occupation, date of birth, gender, and a description of the injury or illness.
4. Next, fill out the 'Employer Information' section, including the employer's federal ID number, company name, nature of business, policy number, and contact information.
5. Indicate the last date the employee worked, whether the employer will continue to pay wages instead of workers' compensation, and any applicable location addresses.
6. Provide the details related to the place of the accident and confirm whether you agree with the description of the accident.
7. In the 'Claims-Handling Entity Information' section, indicate if this is a denied case, a medical-only case, or a lost-time case, filling out any additional required fields.
8. If applicable, provide information regarding the healthcare provider or hospital associated with the injury.
9. Review all the information you have entered to ensure accuracy and completeness.
10. Once satisfied, proceed to save changes, download the form, print it, or share it as needed.

Complete your documents online today to ensure timely and accurate reporting.