Virginia Occupational Injury Illness Report

State:
Multi-State
Control #:
US-AHI-275
Format:
Word; 
Rich Text
Instant download
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Description

This AHI form is used to document an incident of injury or illness that is work-related. The form is to be completed by the employee involved in the incident.

How to fill out Occupational Injury Illness Report?

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FAQ

What are the reporting requirements when an injury occurs?lost time or the need to temporarily or permanently modify work beyond the date of accident,death or permanent disability (amputation, hearing loss, etc.),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.

Filling out a DWC-1 form is actually pretty straightforward....On the form, you will need to only fill out the Employee section, which asks for basic information:Name, date, and address.Date and location of injury.Brief description of injury.List of injured body parts.Social Security Number.

Employers must report work-related fatalities within 8 hours of finding out about it. For any in-patient hospitalization, amputation, or eye loss employers must report the incident within 24 hours of learning about it. Only fatalities occurring within 30 days of the work-related incident must be reported to OSHA.

OSHA requires employers to post a citation near the site of the violation for 3 days for employers who receive citations for violations.

Although the Act authorizes OSHA to require employers to submit reports on any or all injuries and illnesses occurring to their employees, there are currently only three situations where OSHA requires an employer to report occupational injury and illness records to the government.

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.

Division of Workers' Compensation (DWC)

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.

The CA-7 must be filed within one year of the dates claimed, or the date your claim is accepted, whichever is later.

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Virginia Occupational Injury Illness Report