Alaska Injury Report Form
Description
How to fill out Injury Report Form?
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FAQ
(a) The employer shall furnish medical, surgical, and other attendance or treatment, nurse and hospital service, medicine, crutches, and apparatus for the period which the nature of the injury or the process of recovery requires, not exceeding two years from and after the date of injury to the employee.
?Tell your employer about your work-related injury or illness right away. Fill out Form 801 ?Report of Job Injury or Illness? and turn it in to your employer.
WCC ? Workers Compensation Claim Fill out the Report of Injury Form 07-6100 as soon as possible but no later than 30 days after your injury occurred or illness began. Keep a copy of the completed form for your records, and immediately give this form to your employer. You may send a copy to AWCB.
The Employer's First Report of Occupational Injury or Illness form is to be completed by an employer or its workers' compensation insurance carrier to notify the Workers' Compensation Commission of occupational injuries or illnesses that result in incapacity for one day or more.
Tell your supervisor, your employer or "the office" about the injury right away. You must give written notice to your employer within 30 days after the accident or when you think you have an illness caused by work.
EMPLOYER: File the complete First Report of Injury (FROI), form 07-6101, with the Alaska Division of Workers' Compensation by electronic data interchange (EDI), or by mail, within 10 days of receiving this report, per AS 23.30. 070(a).
ALASKA WORKERS' COMPENSATION ACT (ACT). Employers who employ one or more workers must have workers' compensation insurance. An employer must buy the insurance from a licensed insurance company or be self-insured. Your employer cannot require you to pay any part of the insurance premium.