Mississippi Instructions for Employer's First Report of Injury or Occupational Disease

• Category: Mississippi Workers Compensation - Official
• State: Mississippi
• Control #: MS-SKU-0331
• Format: PDF

Description

Instructions for Employer's First Report of Injury or Occupational Disease The Mississippi Instructions for Employer's First Report of Injury or Occupational Disease is a form that must be completed by employers in the state of Mississippi whenever an employee has a work-related injury or illness. The form is designed to provide the employer with an official record of the incident, as well as to serve as a notification of the injury/illness to Mississippi's Workers' Compensation Commission. The form must be completed within seven days of the injury/illness and must include information such as the name and address of the employer, the date and time of the incident, the employee's name and address, a description of the incident, and the type of injury/illness. The form is divided into two main sections: the Employer's Narrative and the Employer's Acknowledgement. In the Employer's Narrative, the employer must provide a detailed description of the incident, including the circumstances leading up to the injury or illness, the type of injury/illness, and any medical treatment that was provided. The Employer's Acknowledgement section requires the employer to acknowledge that they have received the form and that they understand their obligations as an employer under the Mississippi Workers' Compensation Act. There are two types of Mississippi Instructions for Employer's First Report of Injury or Occupational Disease: Mississippi Instructions for Employer's First Report of Injury or Occupational Disease (Form WC-1) and Mississippi Instructions for Employer's First Report of Occupational Disease (Form WC-2).

The Mississippi Instructions for Employer's First Report of Injury or Occupational Disease is a form that must be completed by employers in the state of Mississippi whenever an employee has a work-related injury or illness. The form is designed to provide the employer with an official record of the incident, as well as to serve as a notification of the injury/illness to Mississippi's Workers' Compensation Commission. The form must be completed within seven days of the injury/illness and must include information such as the name and address of the employer, the date and time of the incident, the employee's name and address, a description of the incident, and the type of injury/illness. The form is divided into two main sections: the Employer's Narrative and the Employer's Acknowledgement. In the Employer's Narrative, the employer must provide a detailed description of the incident, including the circumstances leading up to the injury or illness, the type of injury/illness, and any medical treatment that was provided. The Employer's Acknowledgement section requires the employer to acknowledge that they have received the form and that they understand their obligations as an employer under the Mississippi Workers' Compensation Act. There are two types of Mississippi Instructions for Employer's First Report of Injury or Occupational Disease: Mississippi Instructions for Employer's First Report of Injury or Occupational Disease (Form WC-1) and Mississippi Instructions for Employer's First Report of Occupational Disease (Form WC-2).