Workers' Compensation Reporting Procedures - Employees

Immediately report an accident, illness or injury to your supervisor. Include the following information:

1. Full name, address and telephone number.
2. Occupation, date of birth.
3. Social Security Number.
4. Hire date.
5. Date and time of accident/illness or injury.
6. Description of event(s) that led to accident or injury.
7. Description of the injury or illness that occurred, part of body injured.
8. Place/address where injury or accident occurred.