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Get Injured Worker''s Name (first

Submit Reset ME-OW Print U.S. Department of Labor Work Capacity Evaluation Musculoskeletal Conditions Injured Worker 's Name (First, middle, last) Employment Standards Administration Office of Workers.

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Related links form

IL VSD 770.4 2018 CT J-23V 2018 IL VSD 765.3 2018 CT P-142ER 2017

Questions & Answers

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What is workers' compensation? If you get hurt on the job, your employer is required by law to pay for workers' compensation benefits.

If it's an emergency, you should call 911 right away. After the injury, your employee can file a claim with your workers' compensation insurance, also known as workers' comp, to help get important benefits, like medical treatment coverage. There are different state laws for this coverage depending on where you live.

Report the injury or illness to your employer Reporting promptly helps avoid problems and delays in receiving benefits, including medical care. If you don't report your injury within 30 days, you could lose your right to receive workers' compensation benefits.

All employers are required to notify OSHA when an employee is killed on the job or suffers a work-related hospitalization, amputation, or loss of an eye. A fatality must be reported within 8 hours. An in-patient hospitalization, amputation, or eye loss must be reported within 24 hours.

Report your injury immediately to your employer Your employer is responsible for getting you any necessary first aid, and for transporting you to a medical facility if that's what you need. Be sure to keep in touch with your employer if you are off work.

A. Report the injury to your employer by telling your supervisor right away. If your injury or illness developed over time, report it as soon as you learn or believe it was caused by your job. Reporting promptly helps prevent problems and delays in receiving benefits, including medical care you may need.

Call the nearest OSHA office. Call the OSHA 24-hour hotline at 1-800-321-6742 (OSHA).

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232