Get Employer's Basic Report Of Injury P.m. - Macomb County - Macombcountymi

Filing the Employer's Basic Report of Injury is a crucial step for employers to report workplace injuries. This guide provides clear, step-by-step instructions to assist users in completing the form online accurately and efficiently.

Follow the steps to complete the online form correctly.

1. Click the ‘Get Form’ button to access the report and open it for editing.
2. Begin by filling out the employee data section. Include the employee's social security number, date of injury, full name, address, date of birth, sex, number of dependents, and telephone number.
3. Move on to the employer/carrier data. Please provide the employer's name, federal ID number, mailing location code, injury location code, type of business, insurance company name (if applicable), and the last day the employee worked.
4. In the injury/medical data section, detail the specifics of the injury. This includes the city and state of the injury, time of the event, a description of how the injury occurred, and the nature of the injury or illness. Be thorough and precise about the tools, equipment, or materials involved.
5. Next, complete the occupation and wage data section. Record the date hired, total gross weekly wage, and occupation. Confirm if the employee was a volunteer or certified as vocationally handicapped if applicable.
6. Fill out the preparer data section, which requires the preparer's name, signature, telephone number, and the date prepared.
7. Once all sections are completed, review the form for accuracy. Ensure all required fields are filled. Save your changes and choose to download, print, or share the form as necessary.

Complete your documents online efficiently and ensure all workplace injuries are reported promptly.