Get Fra F 6180.98 2003

The FRA F 6180.98 form is essential for documenting railroad employee injuries and illnesses. This guide will provide step-by-step instructions on how to complete this form online with clarity and ease.

Follow the steps to fill out the FRA F 6180.98 accurately.

1. Click the ‘Get Form’ button to access the FRA F 6180.98 form and open it in your online editor.
2. In the first section, enter the 'Railroad' name and 'Case/Incident Number'. This information helps identify the specific incident and the company involved.
3. Next, fill out the 'Employee Information' section. Include the last name, first name, middle initial, date of birth, sex, social security number, hired date, home address (street, city, state, and ZIP code), and home telephone number.
4. Proceed to the 'Facility Information' subsection. Provide the name of the facility where the employee normally reports, including its street address, city, state, and ZIP.
5. In the 'Department Assigned To' field, specify the department in which the employee works.
6. In the 'Activity/Incident/Exposure Description' section, indicate the location of the incident, providing specific site details, city, and county.
7. Answer the question on whether the location is on your premises and fill in the date and time of occurrence, as well as the time shift began and the company personnel notified.
8. Describe the general activity the employee was engaged in prior to the injury or illness and detail any pertinent factors, such as tools or environmental conditions.
9. In the 'Injury/Condition Information' section, provide a detailed description of the injury or condition sustained, including affected body parts and recurrences.
10. Identify all persons and organizations involved in the evaluation and treatment of the condition. Include their facility name, provider, and address.
11. Detail all treatments, procedures, and medications provided for the health condition.
12. Check any consequences resulting from the injury or condition, such as work restrictions, hospitalizations, or medical treatments.
13. If applicable, state whether the case has been reported and whether the employee has had an opportunity to review their file.
14. Complete the preparer's information, including name, title, telephone number, and the date of form completion.
15. Finally, review all entries for accuracy and completeness, then save any changes, download, print, or share the completed FRA F 6180.98 form as needed.

Start filling out the FRA F 6180.98 online to ensure accurate reporting of injuries and illnesses.