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Get Mwcc - Workers Compensation - First Report Of Injury Or Illness
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How to fill out the MWCC - Workers Compensation - First Report of Injury or Illness online
Filling out the MWCC - Workers Compensation - First Report of Injury or Illness is an essential step in reporting workplace injuries or illnesses. This guide provides straightforward instructions to help you complete the form accurately and effectively.
Follow the steps to successfully complete the form online.
- Click the ‘Get Form’ button to obtain the form and open it for editing.
- Begin with the employer section, and provide the employer’s name, address including zip code, and additional relevant details such as the carrier/administrator claim number and jurisdiction.
- Fill in the workplace details, including insurer information and employer’s location, phone number, and SIC code. Ensure you include the appropriate employer FEIN.
- Proceed to the employee section. Input the employee’s name, date of birth, social security number, date hired, and address. Be sure to select the correct sex and marital status.
- Enter details regarding the employee’s occupation/job title, employment status, and the number of dependents.
- Document the occurrence and treatment information, including the date and time of injury or illness, last work date, and details on how the injury or illness occurred. Include any relevant codes.
- In the treatment section, indicate whether safeguards or safety equipment were provided and if they were used. Add details about the hospital and initial treatment type.
- Fill in the witness information and the date the administrator was notified. Also, include the preparer’s name and title.
- Review all the information entered for accuracy. After ensuring everything is correct, you can save your changes, download the form, print it out, or share it as necessary.
Complete your workers compensation forms online today to ensure prompt reporting and support.
Related links form
Within 5 days of your initial examination, for every occupational injury or illness, send two copies of this report to the employer's workers' compensation insurance carrier or the insured employer.
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