Arkansas Report of Occupational Injury or Illness

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Description

This form is used to document information concerning an injury or illness suffered by an employee on company property.

The Arkansas Report of Occupational Injury or Illness is a crucial document used to gather information about workplace injuries and illnesses in the state of Arkansas. It serves as a record-keeping tool for employers, enabling them to create a safer work environment by identifying potential hazards and implementing preventive measures. This report is filed with the Arkansas Workers' Compensation Commission (ACC) and helps in determining the appropriateness of workers' compensation benefits for the affected individuals. The Arkansas Report of Occupational Injury or Illness consists of several sections that capture vital details required to understand and analyze workplace incidents comprehensively. These sections may include: 1. Employer Information: Details such as the employer's name, address, contact information, and identification number. 2. Employee Information: Information related to the injured or ill employee, including their name, job title, department, address, and contact details. 3. Incident Details: This section records the specific date, time, and location of the incident or illness occurrence, as well as a detailed description of the event itself. 4. Injury or Illness Description: Provides space to describe the nature of the injury or illness sustained by the worker. This includes the affected body parts/systems, extent of injury, and medical diagnosis if available. 5. Witness Information: If any witnesses were present during the incident, their names, contact information, and statements can be included. 6. Treatment and Medical Information: This section captures details of medical treatment provided to the injured worker, including the healthcare professional's name, address, and contact information. It also records information about hospitalization, medication, and any ongoing medical care. 7. Lost Work Time: Documents the number of days the employee was unable to work due to the injury or illness, including the start and end dates. 8. Investigation and Preventive Measures: Employers can describe the actions taken to investigate the incident, identify causes, and implement preventive measures to avoid similar incidents in the future. It's important to note that there might not be specific types of Arkansas Report of Occupational Injury or Illness. However, certain variations of the form may exist, depending on the specific requirements of different industries or employers. Some variations may focus on unique aspects of injury or illness reporting, such as in more hazardous industries like construction or manufacturing. In conclusion, the Arkansas Report of Occupational Injury or Illness plays a crucial role in gathering information on workplace incidents, enabling employers, and the ACC to identify areas for improvement and better protect employees' well-being. By accurately documenting the relevant information, employers can work towards reducing accidents, ensuring proper compensation for injured workers, and promoting a safe working environment overall.

How to fill out Report Of Occupational Injury Or Illness?

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FAQ

When an incident is reported quickly it allows the injured worker the opportunity to receive quick and proper treatment that may be needed. Sometimes an employee may believe they have a minor injury and decide not to report it or get the injury evaluated which may cause it to become worse.

From a health and safety perspective, reporting hazards, incidents and injuries is a matter of prevention. The idea is to prevent accidents from happening in the first place. If one has already occurred, then the goal is to prevent it from occurring again.

As an important element of enterprise occupational safety and health management systems, employers need to record information about accidents and diseases as well as dangerous occurrences which have arisen, along with the results of their investigation.

For workers Reporting a workplace injury is your right. If you are unsure about your injury, report it. The sooner we receive your information, the faster we can process your benefits and provide you with the support you need.

An injury or illness is considered by the Occupational Safety and Health Administration to be work-related if an event or exposure in the work environment either caused or contributed to the resulting condition or significantly aggravated a pre-existing condition.

While you do have two years from the date of injury to file a claim with the Arkansas Workers' Compensation Commission, injured employees should not delay. Once you miss this deadline, you will be barred from asserting a claim for workers' compensation benefits.

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.

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.

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

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

More info

How do I file a workers compensation claim in my state?Workers' compensation covers accidental injuries and occupational diseases that arise out of the ... Be sure to report your injury immediately to your supervisor and make sure that they file a First Report of Injury or Illness.WORKERS COMPENSATION ? FIRST REPORT OF INJURY OR ILLNESSWORK PROCESS THE EMPLOYEE WAS ENGAGED IN WHEN ACCIDENT OR ILLNESS EXPOSURE. OCCURRED.21 pages WORKERS COMPENSATION ? FIRST REPORT OF INJURY OR ILLNESSWORK PROCESS THE EMPLOYEE WAS ENGAGED IN WHEN ACCIDENT OR ILLNESS EXPOSURE. OCCURRED. Failure to file a report could result in a $500 fine. V. CLAIM FOR COMPENSATION. A. A claim for an injury other than an occupational disease must be filed ... Select a State below, or find your State on the map: ; Arkansas. SOII/CFOI, Don Cash Phone: 501-682-4542. Fax: 501-682-4754. Mailing address: Arkansas Department ... Click here to complete & submit the form online. Alabama: Employer's First Report of Injury Arkansas: First Report of Injury or Illness If no medical treatment is needed, the employee must complete the Injury Incident Report Form. Failure to report an injury before seeking treatment may ... Workers' comp income benefits in Arkansas will replace most of your employees missing income if they are away from work due to an injury or illness. The Arkansas Department of Labor/Occupational Safety and Health investigates complaints, accidents, and fatalities in public sector workplaces and checks for ... Injuries Requiring No Treatment · Injured employee notifies his/her supervisor. · Supervisor and employee complete an Incident Report Form to record job injuries ...

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Arkansas Report of Occupational Injury or Illness