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Ployees has a work-related injury or illness, you must complete and file this form within 10 days of the injury/illness or be subject to a penalty. For additional information on filing this form please refer to Workers' Compensation Law Section 110 at the end of this form. Type or print neatly. WCB Case Number (if you know it): Date of Injury/illness: / / Carrier Case Number (if you know it): Date of this Report: / / A. EMPLOYER INFORMATION 1. E.
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Allegany FAQ
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All employers are required to notify OSHA when an employee is killed on the job or suffers a work-related hospitalization, amputation, or loss of an eye. A fatality must be reported within 8 hours. An in-patient hospitalization, amputation, or eye loss must be reported within 24 hours.
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Each February through April, employers must post a summary of the injuries and illnesses recorded the previous year. Also, if requested, copies of the records must be provided to current and former employees, or their representatives.
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See CCR title 8, 14300.5(b)(1). You must record any significant work- related injury or illness that is diagnosed by a physician or other licensed health care professional. You must record any work- related case involving cancer, chronic irreversible disease, a fractured or cracked bone, or a punctured eardrum.
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You have the right to: report a work-related injury or illness, and get copies of your medical records. see copies of the workplace injury and illness log. review records of work-related injuries and illnesses.
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Injuries and illnesses that occur while an employee is working at home, including work in a home office, will be considered work-related if the injury or illness occurs while the employee is performing work for pay or compensation in the home, and the injury or illness is directly related to the performance of work ...
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RESPONSIBILITY OF EMPLOYER - 2581.2. The employer is responsible for carrying out state and departmental injury prevention policies. In case of injury this responsibility includes initiating action to obtain prompt medical treatment for injured employees.
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The OSH Act of 1970 requires the Secretary of Labor to produce regulations that require employers to keep records of occupational deaths, injuries, and illnesses. The records are used for several purposes. Injury and illness statistics are used by OSHA.
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Any work-related fatality. Any work-related injury or illness that results in loss of consciousness, days away from work, restricted work, or transfer to another job. Any work-related injury or illness requiring medical treatment beyond first aid.
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