Get Form B Piab

Filling out the Form B Piab is an essential step in the personal injury compensation assessment process in Ireland. This guide provides a clear and structured approach to complete the form accurately and effectively, ensuring that all necessary medical information is submitted for proper assessment.

Follow the steps to fill out the Form B Piab online

1. Press the ‘Get Form’ button to retrieve the form and access it in your preferred editing tool.
2. Begin by entering the PIAB application number, the name of the claimant, and their address at the top of the form. Ensure this information is accurate and up to date.
3. Fill in the claimant's gender, date of birth, and occupation, detailing any changes since the date of the accident. Indicate if the claimant is currently at work, marking the appropriate box for 'Yes' or 'No'.
4. Provide details about the claimant's hand dominance (right or left) and their height, weight, and BMI, noting any changes since the accident date.
5. Document the date of the accident and the examination date. Calculate and enter the total time elapsed since the date of the accident to the examination date.
6. Summarize the brief details of the accident. Include all relevant history regarding injuries sustained immediately after the accident and in the following days.
7. Detail the date treatment was first sought, who provided the treatment, and whether the claimant was hospitalized. Record the duration of the hospital stay and the total length of absence from work.
8. List the number of GP visits and specialist consultations, including the identity of any specialists, if known.
9. Provide a comprehensive account of treatments and investigations conducted, noting any medications and their changes since the accident.
10. Complete the relevant medical history section, indicating if there were any pre-existing conditions or previous accident histories.
11. Have the claimant complete the Neck Disability Index (NDI) and Visual Analogue Scale (VAS) questionnaires included at the end of the form.
12. Ensure all sections are thoroughly filled, make any necessary comments in the 'Opinion/General Comments and Latest Prognosis' section, and sign the document.
13. After completing the form, save your changes, download a copy, print it for your records, or share it as necessary.

Complete your Form B Piab online today to ensure a smooth process for your personal injury assessment.