Wisconsin Occupational Injury Illness Report

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

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.

When do I have to post the annual summary? You must post the summary no later than February 1 of the year following the year covered by the records and keep the posting in place until April 30.

The Employer's First Report of Injury or Disease must be electronically filed with the Worker's Compensation Division within 14 days after the injury. The Supplementary Report on Accidents and Industrial Diseases must be electronically filed with the Worker's Compensation Division by the 30th day after the injury.

3 years from the date of the workplace accident that left you suffering from injuries whether minor or more severe. 3 years from the time you turn 18 years old if the workplace accident happened prior to your 18th This means you must file a claim before you are 21 years old.

The Employer's Report of Occupational Injury or Illness (Form 5020). Every employer is required to file a complete report of every occupational injury or illness to each employee which results in lost time beyond the date of injury or illness or which requires medical treatment beyond first aid.

Employers may require employees to report work-related injuries or illnesses as soon as practicable after they realize they have a work-related injury serious enough to report.

WKC-12-E, Employer's First Report of Injury or Disease.

All employers must notify OSHA within 8 hours of a workplace fatality or within 24 hours of any work-related inpatient hospitalization, amputation or loss of an eye.

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

The Employer's First Report of Injury or Disease must be electronically filed with the Worker's Compensation Division within 14 days after the injury. The Supplementary Report on Accidents and Industrial Diseases must be electronically filed with the Worker's Compensation Division by the 30th day after the injury.

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Wisconsin Occupational Injury Illness Report