Alabama Injury Report Form

State:
Multi-State
Control #:
US-1340837BG
Format:
Word; 
Rich Text
Instant download
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Public form

Description

This form is an example of an injury report form that may be used by a Company in order to report injuries on the job.

How to fill out Injury Report Form?

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FAQ

An Incident Report form might be completed by the staff involved in the incident that occurred or it might be completed by a safety manager on their behalf. See more on how to write an incident report. Incident reporting is the process of recording worksite events, including near misses, injuries, and accidents.

The employer is required to file an Employer's First Report of Injury or Illness [DWC FORM-001 Rev. 10/05] with the injured worker's insurance carrier, and the injured claimant or the claimant's representative within 8 days after the employee's absence from work or receipt of notice of occupational disease.

How to File a Workers' Compensation Claim in Alabama 5 critical steps to take following a workplace injury. Step 1: Notify your employer. Step 2: Seek medical attention. Step 3: Make certain your employer files the necessary form. Step 4: Wait to receive a decision from the insurance company.

Although you are generally prohibited from suing your employer or a co-worker for an on-the-job injury, Alabama law allows you to bring an action against a co-worker when the co-worker's ?willful conduct? caused the injury.

Proper notice of the accident and injury must be given to the employer. (The law requires that notice be given within five days, but in any case notice must be given within ninety days following the accident.

All employers must keep a record of any reportable injury, an injury that leaves a worker incapacitated for over three days, disease, or dangerous occurrence. Your records must include: the date and method of reporting.

Every physician who treats an injured employee must file a complete Form 5021 Doctor's First Report of Occupational Illness or Injury (DFR) with the employer's claims administrator within five days of the initial examination.

If you're the one who discovers the incident, or you have been involved in the situation leading up to it and know more about it than your colleagues, filling out an incident report is your responsibility.

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Alabama Injury Report Form