This is one of the official Workers' Compensation forms for the state of Kentucky.
Kentucky Medical Report Injury
State:
Kentucky
Control #:
KY-107I-WC
Format:
PDF
Instant download
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Description
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FAQ
If you haven't reported your injury, your employer may deny you medical treatment and benefits for missed time from work.Also, if the accident isn't filed immediately, your employer may deny the accident happened or claim that it took place outside of work.
How Long Does an Employer Have to Report an Accident? As with an employee notifying the employer of an accident, the employer should act as soon as possible in notifying the state's workers comp board.The minimum charge is typically $100, but missed or late reporting can result in a $2,500 fine in California.
Find out if your injury is related to work. Tell your supervisor. Get medical help. Make notes and review notes made by others. Report the injury to the Workplace Safety and Insurance Board. Find services.
If there is a serious injury or illness, a death or a dangerous incident, you must report it to us immediately on 13 10 50 as an urgent investigation might be needed. Incidents can be notified 24 hours a day, 7 days a week by calling 13 10 50.
All injuries, no matter how minor, must be reported within 24 hours of the injury.It must be reported to our workers' compensation department in case the injury becomes worse and needs medical attention in the future. That way, the reporting of the injury will not be considered late by the state.
What should I do if I am injured at work? The most important thing for employees to know is that any time you are injured on the job, you should report the injury immediately to a supervisor, in writing if possible. Some states require that notice to the employer be made in writing, while others allow a verbal notice.
Question: How do I file a workers compensation claim in Kentucky? You must submit a completed Application For Resolution of Injury Claim (Form 101, 102, or 103), and attachments, and submit them to the Department of Workers Claims in Frankfort, Kentucky.
In regards to getting fired for getting injured, every employee is granted legal protection from undue backlash and workplace penalties. As an extension of the whistleblower act, you cannot be terminated solely for being injured on-the-job.
Seek Medical Help. If you or someone you know has suffered a personal injury, the very first thing you should do is seek medical attention. Contact an Attorney. Participate in the Investigation. Discuss What Kind of Compensation You Should Receive.