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West Virginia Employee's & Physicians' Report of Occupational Hearing Loss

State:
West Virginia
Control #:
WV-SKU-0509
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PDF
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Description

Employee's & Physicians' Report of Occupational Hearing Loss The West Virginia Employee's & Physicians' Report of Occupational Hearing Loss is a mandatory form that must be completed and submitted by West Virginia employers and physicians when a worker has experienced or is likely to experience a hearing loss due to their employment. It is part of the West Virginia Department of Labor's Injury and Illness Prevention Program. The report must be completed by the employer and physician, and is used to document the noise exposure levels that the worker has been exposed to, and the medical evaluation and treatment that has been provided. The report should include details on the type of hearing loss, the duration and intensity of exposure, and the type of protective equipment used. It also includes questions related to the employee's medical history and any other relevant information. There are two types of West Virginia Employee's & Physicians' Report of Occupational Hearing Loss: the initial report and the annual report. The initial report is required when an employee experiences a hearing loss, and the annual report is required each year thereafter to monitor the employee's hearing.

The West Virginia Employee's & Physicians' Report of Occupational Hearing Loss is a mandatory form that must be completed and submitted by West Virginia employers and physicians when a worker has experienced or is likely to experience a hearing loss due to their employment. It is part of the West Virginia Department of Labor's Injury and Illness Prevention Program. The report must be completed by the employer and physician, and is used to document the noise exposure levels that the worker has been exposed to, and the medical evaluation and treatment that has been provided. The report should include details on the type of hearing loss, the duration and intensity of exposure, and the type of protective equipment used. It also includes questions related to the employee's medical history and any other relevant information. There are two types of West Virginia Employee's & Physicians' Report of Occupational Hearing Loss: the initial report and the annual report. The initial report is required when an employee experiences a hearing loss, and the annual report is required each year thereafter to monitor the employee's hearing.

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West Virginia Employee's & Physicians' Report of Occupational Hearing Loss