Completed Workers’ Compensation Employee Status Report Sample Clauses

Completed Workers’ Compensation Employee Status Report. 2. The Employer’s First Report of Injury Form This must be forwarded to the Risk Management Department within four calendar days of the occurrence. Note: The injured employee should not complete the Employer’s First Report of Injury, but should assist in completion of the form. • Advise the injured worker that written notice must be delivered to the Risk Management Department within four working days of the accident. • Investigate the claim and complete a Supervisor’s Workers’ Compensation Claim Follow-up Report and forward to the Risk Management Department. If the supervisor feels the claim is not valid, the Risk Management Department should be notified of the fact and the supervisor will submit a written statement verifying why he/she feels the claim should not be honored. • Note: All fatalities and any accident involving three (3) or more employees must be reported immediately by telephone to the Risk Management Office at (000) 000-0000. PERFORMED ACTION: BY: The supervisor will work closely with the Risk Management Department on the following:
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Related to Completed Workers’ Compensation Employee Status Report

  • Workers’ Compensation/Employer’s Liability The Contractor shall have, maintain, and provide proof of Workers’ Compensation insurance.

  • Group Health Benefit Plans, Carrier and Premiums 7.1.1 When enrolment and other requirements for group participation in various plans have been met, the Employer will sponsor such plans to the portion agreed upon and such sponsorship shall not exceed that which is authorized or accepted by the benefit agency.

  • Workers’ Compensation/Employer’s Liability Insurance The minimum limits of Workers’ Compensation/Employer’s Liability insurance are: Part One: Part Two: “Statutory” Each Accident $1,000,000 Disease – Policy Limit $1,000,000 Disease – Each Employee $1,000,000

  • ’ Compensation/Employer’s Liability Insurance If Contractor has employees, it shall maintain workers’ compensation insurance as required by law. Employer’s liability limits shall be not less than $1,000,000 for each accident, $1,000,000 as the aggregate disease policy limit, and $1,000,000 as the disease limit for each employee. If Contractor does not have employees, it shall provide a letter, on company letterhead, to the Judicial Council certifying, under penalty of perjury, that it does not have employees. Upon the Judicial Council’s receipt of the letter, Contractor shall not be required to maintain workers’ compensation insurance.

  • ' Compensation & Employer's Liability The Service Provider shall maintain during the life of this Agreement for all of the Service Provider's employees engaged in work performed under this agreement:

  • State of California Public Liability and Workers’ Compensation Program A. The Judicial Council has elected to be self-insured for its motor vehicle, aircraft liability and general liability exposures.

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