The Missouri Report Your Workplace Injury/Occupational Disease or Repetitive Trauma Injury form is required to be completed and filed with the Missouri Division of Workers’ Compensation for any workplace injuries or illnesses sustained by employees. The form is used to document and report the injury or illness and to provide necessary information to the Division of Workers’ Compensation. The form must be completed by the employer and must include the employee’s name, address, date of injury, type of injury, and the name of the physician or other healthcare professional providing treatment. It must also include details about the employer’s safety program, the injury, the employee’s job description, and any safety measures implemented after the injury occurred. There are three types of Missouri Report Your Workplace Injury/Occupational Disease or Repetitive Trauma Injury forms: First Report of Injury or Occupational Disease, Follow-up Report of Injury or Occupational Disease, and Report of Repetitive Trauma Injury. The First Report of Injury or Occupational Disease is used to report the initial injury or illness, while the Follow-up Report of Injury or Occupational Disease is used to report any changes in the employee’s condition or treatment. The Report of Repetitive Trauma Injury is used to report any repetitive trauma injuries that occurred over a period of time.
Missouri Report Your Workplace Injury/Occupational Disease or Repetitive Trauma Injury
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How to fill out Missouri Report Your Workplace Injury/Occupational Disease Or Repetitive Trauma Injury?
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FAQ
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.
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.
Form WC?1 First Report of Injury (FROI). As soon as you have been notified of a work-related injury, please fill out this form and submit it to EMPLOYERS. This form must be completed within 10 days from notice of an accident. Fatalities must be reported within 24 hours.
When a worker is injured, employers/insurers must file a First Report of Injury with the Division within 30 days from knowledge of the injury.
If you don't report your injury within 30 days, you could lose your right to receive workers' compensation benefits.
The Employer's First Report of Injury or Illness provides information on the claimant, employer, insurance carrier and medical practitioner necessary to begin the claims process. Details of the claimant's employment and circumstances surrounding the injury or illness are also requested.
Report Your Injury immediately to your employer or supervisor. Failure to report your injury to your employer within 30 days may jeopardize your ability to receive workers' compensation benefits.
The Second Injury Fund compensates injured employees when a current work-related injury combines with a prior disability to create an increased combined disability. The Second Injury Fund is funded by a surcharge paid by employers.
