Utah Occupational Injury Illness Report
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How to fill out Occupational Injury Illness Report?
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FAQ
After the injury, go directly to your supervisor or boss and tell them exactly what happened. You can tell your boss in person, if you are in the same location, or over the phone if you're in a different location. You'll want to tell them the order of events and the names of anyone who saw the injury occur.
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.
The first order of business is to assess the injury and receive immediate first aid treatment. Assess the situation and if the injury is severe or life threatening, call 911. Notify your supervisor as soon as possible. In the case of an acute injury, report the injury and how it occured to your supervisor.
When one of your workers is injured on the job, you are required by law to report the injury to WCB within 72 hours. Prompt reporting helps us start the claim process and arrange for the help your worker requires.
A. Report the injury to your employer by telling your supervisor right away. If your injury or illness developed over time, report it as soon as you learn or believe it was caused by your job. Reporting promptly helps prevent problems and delays in receiving benefits, including medical care you may need.
DWC-1 Workers Compensation Claim Form. This is the form you will complete and send to EMPLOYERS to initiate the claim process for your employee. This form must be completed and provided to EMPLOYERS within one working day from you becoming aware of a work-related injury or occupational disease.
Struck by workers, equipment, or falling objects These types of injuries can include severe hand injuries, severed limbs or fingers, traumatic head injuries, stress fractures or full bone breaks, blindness, and more.
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...
Facts related to the incident include:The Basics. Identify the specific location, time and date of the incident.The Affected. Collect details of those involved and/or affected by the incident.The Witnesses.The Context.The Actions.The Environment.The Injuries.The Treatment.More items...?
How to Write a Letter Concerning an Accident at WorkSubmit Promptly. Any letter that you write needs to be composed and submitted as soon as possible after the accident occurs.Detail the Incident.Name Witnesses.Describe Any Injuries.Remedies Being Considered.