Washington Report of Accident (ROA) Workplace Injury, Accident or Occupational Disease

State:
Washington
Control #:
WA-SKU-3886
Format:
PDF
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Description

Report of Accident (ROA) Workplace Injury, Accident or Occupational Disease The Washington Report of Accident (ROA) Workplace Injury, Accident or Occupational Disease is a report required by the Washington State Department of Labor & Industries (L&I) for all workplace injuries, accidents, and occupational diseases. It is a form mandated by the state of Washington for employers to provide when an employee is injured, becomes ill, or is exposed to a hazardous work environment. The Washington Report of Accident (ROA) must be completed by the employer and submitted to L&I within four days of the date of the incident. It must include the date, time, and location of the incident, as well as a description of the incident and the injuries sustained. It must also include any witness information and a description of any safety precautions related to the incident. The Washington Report of Accident (ROA) can be used to request workers’ compensation benefits or to dispute any claims made to L&I. It is also used to investigate and determine fault for workplace injuries and illnesses. There are three types of ROA: Workplace Injury, Accident, and Occupational Disease. A Workplace Injury ROA is used to document workplace injuries, such as slips, trips, falls, or cuts. An Accident ROA is used to document accidents, such as vehicle accidents, machinery malfunctions, or explosions. An Occupational Disease ROA is used to document occupational diseases, such as asbestos exposure or repetitive strain injuries.

The Washington Report of Accident (ROA) Workplace Injury, Accident or Occupational Disease is a report required by the Washington State Department of Labor & Industries (L&I) for all workplace injuries, accidents, and occupational diseases. It is a form mandated by the state of Washington for employers to provide when an employee is injured, becomes ill, or is exposed to a hazardous work environment. The Washington Report of Accident (ROA) must be completed by the employer and submitted to L&I within four days of the date of the incident. It must include the date, time, and location of the incident, as well as a description of the incident and the injuries sustained. It must also include any witness information and a description of any safety precautions related to the incident. The Washington Report of Accident (ROA) can be used to request workers’ compensation benefits or to dispute any claims made to L&I. It is also used to investigate and determine fault for workplace injuries and illnesses. There are three types of ROA: Workplace Injury, Accident, and Occupational Disease. A Workplace Injury ROA is used to document workplace injuries, such as slips, trips, falls, or cuts. An Accident ROA is used to document accidents, such as vehicle accidents, machinery malfunctions, or explosions. An Occupational Disease ROA is used to document occupational diseases, such as asbestos exposure or repetitive strain injuries.

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Washington Report of Accident (ROA) Workplace Injury, Accident or Occupational Disease