Washington Report of Accident (ROA) Workplace Injury, Accident or Occupational Disease

State:
Washington
Control #:
WA-SKU-3129
Format:
PDF
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Description

Report of Accident (ROA) Workplace Injury, Accident or Occupational Disease A Washington Report of Accident (ROA) is the form used in the state of Washington to report workplace injuries, accidents, or occupational diseases. It must be completed and submitted to the Department of Labor and Industries (L&I) within eight hours of the incident. The form is used to document the type of injury or illness, the date of the incident, the time of the incident, the location, the name of the injured employee, the contact information of the employee, employer, and other persons involved, and any other relevant information. There are two types of ROA forms that must be submitted: 1. ROA Form 1 — This form is used to report a workplace injury, accident, or occupational disease. 2. ROA Form 3 — This form is used to report a fatality or serious injury or illness that results in permanent disability. The ROA Form 1 must be completed by the employer and submitted to L&I within eight hours of the incident. The form must include detailed information about the incident, including the date and time of the incident, the location, and the name of the injured employee. The form also must include detailed information about the type of injury or illness, the contact information of the employee, employer, and other persons involved, and any other relevant information. The ROA Form 3 must be completed by the employer and submitted to L&I within twenty-four hours of the incident. The form must include detailed information about the fatality or serious injury or illness, including the date and time of the incident, the location, and the name of the injured employee. The form also must include detailed information about the type of injury or illness, the contact information of the employee, employer, and other persons involved, and any other relevant information.

A Washington Report of Accident (ROA) is the form used in the state of Washington to report workplace injuries, accidents, or occupational diseases. It must be completed and submitted to the Department of Labor and Industries (L&I) within eight hours of the incident. The form is used to document the type of injury or illness, the date of the incident, the time of the incident, the location, the name of the injured employee, the contact information of the employee, employer, and other persons involved, and any other relevant information. There are two types of ROA forms that must be submitted: 1. ROA Form 1 — This form is used to report a workplace injury, accident, or occupational disease. 2. ROA Form 3 — This form is used to report a fatality or serious injury or illness that results in permanent disability. The ROA Form 1 must be completed by the employer and submitted to L&I within eight hours of the incident. The form must include detailed information about the incident, including the date and time of the incident, the location, and the name of the injured employee. The form also must include detailed information about the type of injury or illness, the contact information of the employee, employer, and other persons involved, and any other relevant information. The ROA Form 3 must be completed by the employer and submitted to L&I within twenty-four hours of the incident. The form must include detailed information about the fatality or serious injury or illness, including the date and time of the incident, the location, and the name of the injured employee. The form also must include detailed information about the type of injury or illness, the contact information of the employee, employer, and other persons involved, and any other relevant information.

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Washington Report of Accident (ROA) Workplace Injury, Accident or Occupational Disease