South Dakota 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

Your employer is legally responsible for reporting your injury on duty to the Compensation Fund within seven (7) days of receiving notice from you and within fourteen (14) days when it is an occupational disease as well as submitting the necessary forms and documents.

Provide first aid and medical care It is the prime responsibility of an employer to provide immediate first aid and medical treatment, wherever required. Report the injury- After the injury, an employer should enter a description of the injuries in their register.

The DPSA provides employees with injury-on-duty leave with pay when an employee is unable to work, due to an accident or illness directly related to their job or worksite. Injury- on-duty leave without pay is provided to cover extended periods of absence due to injury.

When & How to Document Workplace InjuryGet to the site as quickly as possible.Ensure the area is safe to enter.Make sure the injured/ill person is receiving first-aid or medical attention.Identify any witnesses.Record the scene with photos (ideally with date and time stamp) or sketches.Safeguard any evidence.More items...

Get emergency treatment if needed Tell the medical staff that your injury or illness is job-related. If you can safely do so, contact your employer for further instructions. If you don't need emergency treatment, make sure you get first aid and see a doctor if necessary.

What to do when an injury occurs: SupervisorsCall the ambulance if necessary.Call as soon as possible to report all serious injuries: 1-877-682-7778.Remove the equipment from service (if applicable).Tag the equipment for identification (if applicable).Call Larry Wong at 510-987-9772 for inspection.More items...

The employer must report a workplace injury within 7 days or within 14 days of finding out that you have an occupational disease.

If the employee is booked off due to an IOD for 4 days or longer, but less than 3 months, the employer must pay the injured employee at a rate of at least 75% of his earnings, from the first day, until the employee returns to work.

Supervisors should, if appropriate, provide injured employee with alternative work assignment to accommodate any medical limitations, or provide light restricted duty assignments whenever possible.

Employers who opt for coverage in the South Dakota Workers' Compensation program gain legal protection against claims that their negligence caused an employee injury. The program covers the cost of medical expenses and partial lost wages for workplace injuries and occupational diseases.

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South Dakota Injury Absence Report