Workers injured on the job in Delaware will likely hear the term “First Report of Occupational Injury” at some point while moving through the workers' compensation claims process. Though injured workers have no direct involvement with the First Report of Occupational Injury, this form plays a vital role in Delaware workers' compensation claims. Read on to learn everything you need to know about this important form.
About Delaware Workers' Compensation
In Delaware, when a worker sustains an on-the-job injury they may be entitled to workers' compensation benefits such as coverage of related medical expenses, temporary total or partial disability (lost wage) payments, and permanent partial impairment benefits. These benefits are generally available to injured workers, regardless of who was responsible for the workplace accident and subsequent injuries.
The workers' compensation claims process begins immediately after the workplace incident—when the worker reports the accident and injuries to their employer, and requests medical services. This is when the First Report of Occupational Injury form comes into the picture.
About the First Report of Occupational Injury Form
After receiving an accident report and request for medical services from an injured employee, the employer is responsible for completing a First Report of Occupational Injury form. Available from the Delaware Office of Workers' Compensation, this single-page form includes the following information:
- The injured employee's name, address, age, sex, date of birth, Social Security number, occupation, wage, hours worked, and length of employment
- The employer's name, address, phone number, and type of business
- The workers' compensation insurance carrier's address, phone number, and the policy or carrier case number
- Relevant dates and times, including the date of the injury, the date of the report, the employee's normal starting time, the date the employer knew of the injury, the date disability began, the date of the last full day paid, and a date of death for cases involving a fatal injury
- A description of the injury, the department where the incident occurred, and the work process involved
- A list of all the materials, chemicals, and equipment the employee was using when the incident occurred
- An explanation of what the employee was doing at the time of the injury
- A description of how the injury occurred
- The name and address of the physician or hospital treating the injured employee
What Happens to the Completed Form?
Employers are required to submit the completed First Report of Occupational Injury form to their workers' compensation insurance carrier within 10 days of the date of the workplace accident and injury. While the employer must file the original form with the workers' compensation insurance carrier, they're also tasked with making three copies—one to submit to the Office of Workers' Compensation, one for their own records, and one for the employee's records.
What Happens If the Employer Fails to Complete the Form?
Delaware state law requires employers to complete and submit a First Report of Occupational Injury form any time a workplace accident leads to an injury, regardless of how minor. Employers who fail to file a First Report of Occupational Injury form after an accident may face fines of up to $250. A skilled personal injury attorney can follow up on this form and other important paperwork to ensure that the workers' compensation claims process goes as smoothly as possible.
Consult an Experienced Workers' Compensation Attorney
If you were injured in an on-the-job accident in Delaware, it's important to protect your rights and your ability to collect the workers' compensation benefits you need and deserve. A knowledgeable workers' compensation attorney can represent your best interests throughout the workers' compensation claims process.
Do you have questions about a workers' compensation claim? The experienced attorneys and legal staff with the Morris James Personal Injury Group have answers. Our firm offers free, no-obligation initial consultations for prospective clients—contact us today to schedule an appointment for your free consultation.