Tennessee First Report of Injury (TERI) is a form that is used to report workplace injuries and illnesses to the Tennessee Department of Labor & Workforce Development. The TERI must be completed and submitted to the Department within seven days of the employee being injured or made aware of an illness. This form is used to help the Department identify potential workplace hazards and to ensure that employers are providing a safe work environment for their employees. There are two types of TERI forms: a Single Incident Report and a Multiple Incident Report. The Single Incident Report should be used to report a single incident of injury or illness. The Multiple Incident Report should be used to report multiple incidents of injury or illness that occurred within a single calendar year. Both forms require the employer to provide information about the incident such as the date and time of the injury, the type of injury, and the name of the injured individual. They also require the employer to provide information about the workplace such as the date the injury occurred, the type of work being performed, and any safety measures that were in place at the time of the incident.
Tennessee First Report of Injury
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FAQ
If you were injured at work, you should promptly notify your employer. In Tennessee, you need to report your work-related injury to your supervisor within 15 days of the accident (or the date when a doctor first tells you that your injury is work-related) so that the proper forms and paperwork can be completed.
After an injury or illness occurs, your employer must: Provide a workers' compensation claim form to you within one working day a work-related injury or illness is reported. Return a completed copy of the claim form to you within one working day of receipt.
The Employer's First Report of Injury or Illness provides information on the claimant, employer, insurance carrier and medical practitioner necessary to begin the claims process. Details of the claimant's employment and circumstances surrounding the injury or illness are also requested.
Medical Care and Paperwork Fill out a First Report of Injury (Form C-20) and file the form with its insurance adjuster within one (1) working day of its knowledge of the injury. The claim must be reported to the adjuster even if the employer feels the claim is not work-related.
After an injury or illness occurs, your employer must: Provide a workers' compensation claim form to you within one working day a work-related injury or illness is reported. Return a completed copy of the claim form to you within one working day of receipt.
The Employer Obligations after a Non-workplace Injury Even though the employee has been injured outside of work, the employer still has responsibilities. Employers must allow the employee to take time off work to recover from the injury and undergo medical treatment.
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 first order of business is to assess the injury and receive immediate first aid treatment. Assess the situation and if the injury is severe or life threatening, call 911. Notify your supervisor as soon as possible. In the case of an acute injury, report the injury and how it occured to your supervisor.