Get First Report Of Injury Fillable Georgia

Filling out the First Report of Injury Fillable Georgia form is an essential step in ensuring that an employee's injury or occupational disease is documented accurately. This guide will provide you with clear, step-by-step instructions to help you navigate the form efficiently and correctly.

Follow the steps to complete the form accurately.

1. Click ‘Get Form’ button to access the document and open it in an online editor.
2. Begin by filling out the 'Identifying Information' section. Here, enter the employee's last name, first name, middle initial, and date of injury. You'll also need to include the employee's social security number or board tracking number.
3. In the 'Employee' and 'Employer' sections, provide the necessary identifying information, including phone numbers and email addresses, as well as the employer’s name, address, and NAICS code.
4. Complete the 'Employment/Wage' section by inputting the wage rate at the time of injury, including how often the employee is paid (hourly, daily, weekly, or monthly), the number of days worked per week, and any other employment-related information.
5. In the 'Injury/Illness & Medical' section, detail the type of injury or illness, the body part affected, and how the injury occurred. Include information about the treating physician and initial treatment given.
6. Fill out the 'Income Benefits' section where you include details regarding disability payments, if applicable. Make sure to note dates related to compensation paid and the type of disability sustained.
7. If applicable, complete the 'Notice to Controvert Payment of Compensation' section by stating the reasons for any denial of benefits.
8. Carefully review all fields for accuracy and completeness before finalizing your form. Once satisfied, you can save changes, download, print, or share the form as needed.

Complete the First Report of Injury Fillable Georgia online to ensure prompt reporting and processing of workplace injuries.