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Connecticut Employer's First Report of Occupational Injury or Illness

State:
Connecticut
Control #:
CT-FRI-WC
Format:
PDF
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Description

Employer's First Report of Occupational Injury or Illness The Connecticut Employer’s First Report of Occupational Injury or Illness is a form used to report workplace injuries and illnesses that occur in Connecticut. This form is required to be completed and filed with the Connecticut Department of Labor for any workplace injury or illness, regardless of whether the employee seeks medical attention or misses work due to the injury or illness. The form must be completed within 24 hours of the employer being notified of the incident. The Connecticut Employer’s First Report of Occupational Injury or Illness has two parts. The first part is the general information section, which includes information about the employer, the injured or ill employee, and details of the incident. The second part is the medical section, which includes the medical diagnosis of the injury or illness, the medical provider, and any medical treatment that was provided. The two types of Connecticut Employer’s First Report of Occupational Injury or Illness are the Initial Report of Injury or Illness and the Follow-up Report of Injury or Illness. The Initial Report of Injury or Illness must be completed within 24 hours of the employer being notified of the incident. The Follow-up Report of Injury or Illness must be filled out within seven days of the initial report or when the employee returns to work, whichever comes first.

The Connecticut Employer’s First Report of Occupational Injury or Illness is a form used to report workplace injuries and illnesses that occur in Connecticut. This form is required to be completed and filed with the Connecticut Department of Labor for any workplace injury or illness, regardless of whether the employee seeks medical attention or misses work due to the injury or illness. The form must be completed within 24 hours of the employer being notified of the incident. The Connecticut Employer’s First Report of Occupational Injury or Illness has two parts. The first part is the general information section, which includes information about the employer, the injured or ill employee, and details of the incident. The second part is the medical section, which includes the medical diagnosis of the injury or illness, the medical provider, and any medical treatment that was provided. The two types of Connecticut Employer’s First Report of Occupational Injury or Illness are the Initial Report of Injury or Illness and the Follow-up Report of Injury or Illness. The Initial Report of Injury or Illness must be completed within 24 hours of the employer being notified of the incident. The Follow-up Report of Injury or Illness must be filled out within seven days of the initial report or when the employee returns to work, whichever comes first.

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Connecticut Employer's First Report of Occupational Injury or Illness