Wyoming Accident - Injury Report

State:
Multi-State
Control #:
US-429EM
Format:
Word; 
Rich Text
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Description

This form is used to document accidents and/or work-related injuries.

How to fill out Accident - Injury Report?

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FAQ

How does workers' comp work in Wyoming? The goal of workers' compensation insurance is to help employees recover from a work injury and return to their job. It covers the cost of medical bills related to a workplace injury or occupational disease, and also covers part of their lost wages.

Workers' Compensation Insurance in Wyoming can be purchased from private insurance companies authorized by the state to provide coverage. The Assigned Risk Pool, or an alternate State Insurance Fund, is available for businesses that are unable to find coverage from a private company.

If you get injured at work, it is essential that you document your injuries as soon as possible. By documenting the details of your injury early when it is fresh in your mind, you will be able to get the most factually accurate account of the events leading up to and after your injury.

Documents for the Injury Most evidence that supports a personal injury case exists in documentation. These items may include records such as medical data and important forms for insurance. Others exist in bills, incident reports and statements.

Read on now for the four steps that you should take after being injured on a construction site.Seek Medical Help. No matter how big or small the injury, it is essential that you seek medical help immediately.Write a Detailed Report of What Happened.Claim Compensation.Work on Recovery.

Requests for crash reports can be made in one of three ways:In person at the Cheyenne WYDOT Office, 5300 Bishop Blvd.Over the phone by calling Highway Safety at (307) 777-4450.By mail to the following address. (Please specify if you want to receive your report via paper copy, email or fax).

When & How to Document Workplace InjuryGet to the site as quickly as possible.Ensure the area is safe to enter.Make sure the injured/ill person is receiving first-aid or medical attention.Identify any witnesses.Record the scene with photos (ideally with date and time stamp) or sketches.Safeguard any evidence.More items...

An injured worker's wage paid is 66 2/3% of actual wage. The weekly payment has no minimum. The weekly maximum is $779, 100% of the Wyoming state average weekly wage. Maximum period of payments is 24 months.

Every incident report you file should contain a minimum of the following:Type of incident (injury, near miss, property damage, or theft)Address.Date of incident.Time of incident.Name of affected individual.A narrative description of the incident, including the sequence of events and results of the incident.More items...?

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Wyoming Accident - Injury Report