GroundRules
20 CFR 702.202: Employer's report; form and contents.
Where this section sits in the code
- Title 20—Employees' Benefits
- CHAPTER VI—OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR
- SUBCHAPTER A—LONGSHOREMEN'S AND HARBOR WORKERS' COMPENSATION ACT AND RELATED STATUTES
- PART 702—ADMINISTRATION AND PROCEDURE
- Subpart B—Claims Procedures
The employer's report of an employee's injury or death shall be in writing and on a form prescribed by the Director for this purpose, and shall contain:
(a) The name, address and business of the employer;
(b) The name, address, occupation and Social Security Number (SSN) of the employee;
(c) The cause, nature, and other relevant circumstances of the injury or death;
(d) The year, month, day, and hour when, and the particular locality where, the injury or death occurred;
(e) Such other information as the Director may require.
Collected 2026-08-27T02:24:45Z. Source file · JSON