New Hampshire Injury Report Form
Description
How to fill out Injury Report Form?
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FAQ
Workers' Compensation for New Hampshire Workers. If you are hurt at work, workers' compensation (or "workers' comp") pays your medical bills. It also pays 60% of your lost wages after you miss more than three days of work. Workers' compensation is a type of insurance that all employers MUST provide.
Timeframes for Filing a Claim The New Hampshire law states: RSA 281-A:19 "The injured worker has two (2) years from the date of injury to notify the employer of his/her injury in order to make a claim for benefits.
New Hampshire Workers' Compensation & First Report of Injury Once you fill out the form, you can: Fax it to: 603-271-6149. Mail it to: Workers' Compensation Division, NH Department of Labor, 95 Pleasant St., Concord, NH 03301. Email it to: WorkersComp@dol.nh.gov.
How much does workers' compensation insurance cost in New Hampshire? The average cost of workers' compensation in New Hampshire is $35 per month. Your workers' comp premium is calculated based on a few factors, including: Payroll.
If you get hurt on the job, your employer is required by law to pay for workers' compensation benefits. You could get hurt by: One event at work. Examples: hurting your back in a fall, getting burned by a chemical that splashes on your skin, getting hurt in a car accident while making deliveries.