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WC1EMPLOYERS FIRST REPORT OF INJURY OR OCCUPATIONAL DISEASEGEORGIA STATE BOARD OF WORKERS' COMPENSATION EMPLOYERS FIRST REPORT OF INJURY OR OCCUPATIONAL DISEASENOTE: FAILURE TO SUBMIT THIS REPORT.

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How to fill out the WC-1 employers first report of injury or occupational disease online

Completing the WC-1 employer's first report of injury or occupational disease is an important process for documenting workplace incidents. This guide provides clear, step-by-step instructions on how to fill out the form online to ensure accurate submission and compliance.

Follow the steps to complete the form accurately and effectively.

  1. Click ‘Get Form’ button to access the WC-1 form and open it in your preferred online editor.
  2. Begin filling out Section A, which includes identifying information for the employee. Enter the employee's last name, first name, middle initial, birthdate, phone number, and email, along with their mailing address, city, state, and zip code.
  3. Provide the employer's details in Section A, including the employer's name, NAICS code, nature of business, mailing address, phone number, and employer FEIN.
  4. Fill in the insurer or self-insurer's information, including the name, FEIN, and file number.
  5. Input the employment and wage details, specifying the date the employee was hired, job classification code, number of days worked per week, and the wage rate at the time of injury or disease.
  6. In the injury/illness and medical section, note the time of injury, county of injury, and date employer learned of the injury. Include the type of injury/illness and body part affected.
  7. Indicate the treating physician, initial treatment given, and the hospital or treating facility's information. If applicable, include the date the employee returned to work.
  8. Complete Section B if applicable, detailing previously paid medical benefits, average weekly wage, and any disabilities noted.
  9. If applicable, complete Section C to indicate reasons for denying benefits or Section D for situations with no indemnity benefits due.
  10. Conclude by including the name, signature, and contact information of the person filing the form. Ensure all information is accurate before finalizing.
  11. Finally, save your changes, download, print, or share the completed form as necessary.

Start filling out your WC-1 form online today to ensure timely and accurate reporting of workplace injuries.

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Supervisor Responsibilities When an injury does occur, supervisors are expected to directly respond and assist the injured employee in receiving the appropriate medical treatment. A supervisor, should never be in a situation where one of their employees is injured and they don't know about it.

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

Form LIBC-344 First Report of Injury (FROI). As soon as you have been notified of a work-related injury, please fill out this form and submit it to EMPLOYERS. This form must be completed within 10 days from notice of a work-related injury. Fatalities must be reported within 24 hours.

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.

Report the Injury If you are injured at work, you should immediately (or as soon thereafter as possible) report your injury to your employer or immediate supervisor. Your employer is required to fill out a form, sometimes called a "First Report of Injury," for every injury which occurs in the workplace.

The employer is required to file an Employer's First Report of Injury or Illness [DWC FORM-001 Rev. 10/05] with the injured worker's insurance carrier, and the injured claimant or the claimant's representative within 8 days after the employee's absence from work or receipt of notice of occupational disease.

The Employer's Report of Occupational Injury or Illness (Form 5020). Every employer is required to file a complete report of every occupational injury or illness to each employee which results in lost time beyond the date of injury or illness or which requires medical treatment beyond first aid*.

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Fill WC-1 EMPLOYERS FIRST REPORT OF INJURY OR OCCUPATIONAL ...

California law requires employers to report within five days of knowledge every occupational injury or illness which results in lost time beyond the. Describe your injury completely. 2. Complete Section A of this Form immediately upon your knowledge of an injury and send the WC-1 to your insurance company or self- insurer claims office. Your employer must give or mail you a claim form within one working day after learning about your injury or illness. 2. Complete Section A of this form immediately upon your knowledge of an injury and send the WC-1 to your insurance company or self-insurer claims office.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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 WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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