New Hampshire Employer's Supplemental Report of Injury

State:
New Hampshire
Control #:
NH-SKU-1169
Format:
PDF
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Description

Employer's Supplemental Report of Injury The New Hampshire Employer's Supplemental Report of Injury is a form used by employers in New Hampshire to report workplace injuries to the state’s Workers' Compensation Division. This report is required by law when an employee suffers a work-related injury or illness that requires medical treatment, results in lost wages, or requires the employee to be absent from work for more than three days. The report includes information such as the date and location of the incident, the type of injury, and the employee's name, address, occupation, and Social Security number. It also requires employers to provide details about the incident, the type of care provided or recommended, and any changes in the employee's condition. There are two types of New Hampshire Employer's Supplemental Report of Injury: Form WC-14A for non-fatal injuries and Form WC-14B for fatal injuries. Employers must submit the appropriate form within 14 days of the injury or death.

The New Hampshire Employer's Supplemental Report of Injury is a form used by employers in New Hampshire to report workplace injuries to the state’s Workers' Compensation Division. This report is required by law when an employee suffers a work-related injury or illness that requires medical treatment, results in lost wages, or requires the employee to be absent from work for more than three days. The report includes information such as the date and location of the incident, the type of injury, and the employee's name, address, occupation, and Social Security number. It also requires employers to provide details about the incident, the type of care provided or recommended, and any changes in the employee's condition. There are two types of New Hampshire Employer's Supplemental Report of Injury: Form WC-14A for non-fatal injuries and Form WC-14B for fatal injuries. Employers must submit the appropriate form within 14 days of the injury or death.

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New Hampshire Employer's Supplemental Report of Injury