Alaska Occupational Injury Illness Report

State:
Multi-State
Control #:
US-AHI-275
Format:
Word; 
Rich Text
Instant download
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Description

This AHI form is used to document an incident of injury or illness that is work-related. The form is to be completed by the employee involved in the incident.

How to fill out Occupational Injury Illness Report?

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FAQ

Employers must report work-related fatalities within 8 hours of finding out about it. For any in-patient hospitalization, amputation, or eye loss employers must report the incident within 24 hours of learning about it. Only fatalities occurring within 30 days of the work-related incident must be reported to OSHA.

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.

Time Limits You must report your injury in writing to your employer within 30 days of your injury. If your workers' compensation insurer denies you benefits, you have two years to file a claim against the insurer.

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.

OSHA requires employers to post a citation near the site of the violation for 3 days for employers who receive citations for violations.

Typically, workers' compensation disability benefits pay workers 80 percent of their spendable weekly wage. Spendable weekly wage is equal to your take-home pay, or your gross pay minus all payroll tax deductions. Payment is made every two weeks, similar to many wage schedules.

The CA-7 must be filed within one year of the dates claimed, or the date your claim is accepted, whichever is later.

The employer must report a workplace injury within 7 days or within 14 days of finding out that you have an occupational disease.

A Notice of Controversion is, simply put, a denial of your workers' compensation claim under the Defense Base Act (or a claim under the Longshore and Harbor Workers' Compensation Act). If you received a Notice of Controversion in connection with a Defense Base Act claim, then you should read on.

You must submit an injury report (Form 07-6100) to your employer within 30 days of your injury. If you fail to do so, your claim for benefits may be denied. Once your employer receives the report, it should notify its insurance company and the Alaska Workers' Compensation Board (AWCB).

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Alaska Occupational Injury Illness Report