Injury Loss Personal Forum
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FAQ
What to include in a work incident report The date and time of the incident. The name of the witness or author of the report. A detailed description of the events. The names of the affected parties. Other witness statements or important information. The result of the incident.
Injury and Lost Time Incident Report Sample Type of incident (injury, near miss, property damage, or theft) Location (Address) Date/time of incident. Name. Name of supervisor. Description of the incident, including specific job site location, the sequence of events, and the results of the event.
PENNSYLVANIA WORKERS' COMP LAWS Pennsylvania law requires that employees notify their employer of a workplace accident within 120 days of the accident. Failure to do so may bar the employee from his or her right to receive workers' compensation benefits.
Dear [Supervisor Name]: I am respectfully presenting this letter as written notice that I was involved in a work-related accident on [date of incident] at approximately [time of incident]. [I was injured / I became ill] when [give clear details involving the accident, including what led up to it].
Medical care must be paid for by your employer if you get hurt on the job ? whether or not you miss time from work. You may be eligible to receive benefits even if you are a temporary or part-time worker. You don't have to be a legal resident of the United States to receive most workers' compensation benefits.