New Jersey Injury Absence Report

State:
Multi-State
Control #:
US-AHI-276
Format:
Word; 
Rich Text
Instant download
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Public form

Description

This AHI form is used to document an absence due to work-related injury. The form also includes the number of hours lost due to the injury. This form must be submitted prior to the close each pay period.

How to fill out Injury Absence Report?

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FAQ

To qualify for Family Leave Insurance in 2022, you must have worked 20 weeks earning at least $240 weekly, or have earned a combined total of $12,000 in the base year. The wages earned during your base year will determine the amount of weekly benefits you may receive, and the total amount you can claim in a given year.

A report of the occupational injury/illness should be made with the employer in a timely manner. Employers typically request that employees report occupational injuries/illnesses immediately but no later than 24 to 48 hours after the incident.

Employers may require return to work notes. That said, employers may not require a doctor's note as proof of the employee's need to have used leave for a permitted ESLL purpose in the first place.

This is important: You have only two years from the date of your injury or the last compensation check you receive (including a medical payment) in which to file a Claim Petition. Even if you apply first for an informal hearing, the clock does not stop running on this two-year time limit.

Accident at work claim time limit: For accidents at work, you will have three years from the date of your workplace accident to claim. Slip, trip or fall accident: Injuries that occur from a slip, trip or fall have a three-year time limit from the date of accident.

Documentation. Your employer can require reasonable documentation if you use earned sick leave on three or more consecutive workdays, or on certain dates specified by the employer.

Although the general rule of thumb is that you must report an incident and your injury within 14 days, there are some exceptions to this.

Employers may require return to work notes. That said, employers may not require a doctor's note as proof of the employee's need to have used leave for a permitted ESLL purpose in the first place.

Under the New Jersey Security and Financial Empowerment Act ("NJ SAFE Act"), employees have the right to take up to 20 days of unpaid time off necessary because they, or a member of their immediate family, has been a victim of domestic violence or sexual assault.

Although the general rule of thumb is that you must report an incident and your injury within 14 days, there are some exceptions to this.

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New Jersey Injury Absence Report