FIRST REPORT OF ALLEGED
OCCUPATIONAL INJURY OR ILLNESS
A. In every case of reportable injury arising out of and in the course of employment, whether resulting from accident or from diagnosed occupational disease, the employer or its insurer or risk management pool shall file a report thereof with the compensation court, specifically stating the nature and extent of the injury. Such first report of alleged occupational injury or illness shall be filed within 10 days after the employer or insurer or risk management pool has been given notice or has knowledge of such injury.
B. Except as otherwise approved by the administrator of the compensation court, all first reports of alleged occupational injury or illness shall be filed electronically in the form and manner and to include the content prescribed by the administrator. With approval of the administrator, such reports may be filed by means of the paper First Report of Alleged Occupational Injury or Illness (Form 1 ), an exact copy of which appears on the two pages following this rule. The mandatory fields identified on the back of the Form 1 must be completed before the report will be deemed filed with the court. Blank forms for paper reports are furnished by the administrator upon request.
C. No report of alleged occupational injury or illness shall be deemed filed with the court until the report has been received and accepted by the court. Sections 48-144, 48-144.01, 48-163, 48-165, RRS. 2010.
Effective date: December 15, 2011.