Injury / Illness Report Form - Delaware

Injury / Illness Report Form - Delaware

Injury/Illness Report Form is a legal document that was released by the Delaware Department of Human Resources - a government authority operating within Delaware.

FAQ

Q: What is an Injury/Illness Report Form?
A: It is a form used to report an injury or illness that occurred in Delaware.

Q: Who is required to complete an Injury/Illness Report Form?
A: Employers are responsible for completing the form when an employee gets injured or becomes ill.

Q: What information is needed on the form?
A: The form requires details about the employee, the nature of the injury or illness, and how it occurred.

Q: When should the form be completed?
A: The form should be completed as soon as possible after the injury or illness occurs.

Q: Who should I submit the form to?
A: The completed form should be submitted to the Delaware Department of Labor within ten days of the incident.

Q: Are there any penalties for not submitting the form?
A: Yes, failure to submit the form may result in penalties or fines for the employer.

Q: Is the Injury/Illness Report Form confidential?
A: Yes, the information provided on the form is confidential and will only be used for statistical purposes.

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Form Details:

  • Released on January 1, 2006;
  • The latest edition currently provided by the Delaware Department of Human Resources;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Delaware Department of Human Resources.

Download Injury / Illness Report Form - Delaware

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