Employers First Report Of Work Injury Or Illness {LB-0021} | Pdf Fpdf Docx | Tennessee

 Tennessee   Workers Compensation 
Employers First Report Of Work Injury Or Illness {LB-0021} | Pdf Fpdf Docx | Tennessee

Last updated: 10/30/2023

Employers First Report Of Work Injury Or Illness {LB-0021}

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Description

EMPLOYER’S FIRST REPORT OF WORK INJURY OR ILLNESS. The use of this form is required under the provisions of the Tennessee Workers' Compensation Law and must be completed and filed with your insurance carrier immediately after notice of injury. It is a crime to knowingly provide false, incomplete, or misleading information to any party to a workers' compensation transaction for the purpose of committing fraud. Penalties include imprisonment, fines, and denial of insurance benefits. www.FormsWorkflow.com

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