Form Wc 8388G – Fill Out and Use This PDF

The WC 8388G form serves as a First Report for occupational injuries or diseases in the State of Delaware, required to be filled out and submitted to the Office of Workers' Compensation. This document is vital for both employers and employees, detailing necessary information related to the workplace incident, including the nature of the injury or disease, treatment provided, and any compensation agreement. Filling out this form accurately ensures that all parties are informed and that appropriate steps are taken for the welfare of the employee. To start the process of filling out the form, click the button below.

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Form Wc 8388G PDF Details

In the State of Delaware, navigating the complexities of workplace injuries requires a comprehensive understanding facilitated by specific documentation like the WC 8388G form. At the heart of the workers' compensation process, this form serves as the First Report of Occupational Injury or Disease, ensuring that all pertinent details about the incident are meticulously recorded and communicated to relevant parties. From employer details to the intricate specifics of the injury and the circumstances under which it occurred, the form is structured to capture a wide range of data including, but not limited to, the employee's personal information, the nature of the injury or disease, and the treatment provided. Moreover, it outlines critical steps for both employer and employee post-accident, advocating for expedited medical treatment, accurate record-keeping, and timely communication with Delaware's Office of Workers' Compensation. Such rigorously detailed documentation is indispensable for facilitating the claims process, determining compensation eligibility, and ultimately, ensuring the injured or ill employee receives the necessary support and benefits. The WC 8388G form is thus a crucial tool within the workers' compensation framework, symbolizing the Delaware Department of Labor’s commitment to protecting workers while fostering a transparent and efficient pathway to recovery and compensation.

Question	Answer
Form Name	Form Wc 8388G
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	8388g, form, uc1 delaware, uc-1

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ALL COPIES OF FIRST REPORT MUST BE TYPED OR PRINTED

STATE OF DELAWARE

	FIRST REPORT	CASE OR FILE NO.
Department of Labor	OF
Office of Workers' Compensation	OCCUPATIONAL INJURY
P.O. Box 9954	OCCUPATIONAL INJURY
P.O. Box 9954	OR DISEASE
Wilmington, DE 19809-9954	OR DISEASE
Telephone 302-761-8200		EMPLOYER’S UC REPORTING NUMBER

EMPLOYEE
EMPLOYER
DATES
INJURY OR	DISEASE

OCCURRENCE

EMPLOYEE:

FIRST

MIDDLE

LAST

2. EMPLOYEE SOCIAL SECURITY NO.

ADDRESS - INCLUDE COUNTY AND ZIP CODE

4. MALE

5. EMPLOYEE TELEPHONE NUMBER (INCLUDE AREA CODE)

FEMALE

(

)

DATE OF BIRTH

7. AGE

8. WAGE

WEEKLY HOURS WORKED

10.

OCCUPATION (REGULAR)

11. DEPARTMENT OR DIVISION REGULARLY EMPLOYED

12. HOW LONG EMPLOYED

13.

EMPLOYER

14. PERSON MAKING OUT THIS REPORT

15.

ADDRESS - INCLUDE COUNTY AND ZIP CODE

16. EMPLOYER TELEPHONE NUMBER (INCLUDE AREA CODE)

(

)

17.

MAILING ADDRESS - IF DIFFERENT THAN ABOVE

18.

NATURE OF BUSINESS - TYPE OF MFG., TRADE, CONSTRUCTION, SERVICE, ETC.

19.

DATE OF REPORT

20. DATE OF INJURY AND TIME

21. NORMAL STARTING TIME

22. IF EMPLOYEE BACK TO WORK

23. AT SAME WAGE

GIVE DATE:

YES

24.

IF FATAL INJURY, GIVE DATE

25. DATE EMPLOYER KNEW OF INJURY.

26. DATE DISABILITY BEGAN.

27. LAST FULL DAY PAID - DATE

OF DEATH.

28.DESCRIBE THE INJURY/ILLNESS AND PART OF BODY AFFECTED.

29.SPECIFY THE DEPARTMENT WHERE INCIDENT OCCURRED AND THE WORK PROCESS INVOLVED.

30.LIST THE EQUIPMENT, MATERIALS, AND CHEMICALS EMPLOYEE WAS USING WHEN THE INCIDENT OCCURRED, E.G. ACETYLENE.

31.DESCRIBE THE EMPLOYEE’S ACTIVITY AT THE TIME OF INJURY OR ILLNESS, I.E.

32.DESCRIBE HOW THE INJURY/ILLNESS OCCURRED.

33. NAME OF PHYSICIAN

34. PHYSICIAN’S ADDRESS

35. HOSPITAL (IF APPLICABLE)

36. HOSPITAL ADDRESS

WORKER’S COMPENSATION INSURANCE COMPANY AND COMPLETE ADDRESS (PREPRINT OR STAMP INCLUDE IAB CODE) 37. (THIS SECTION MUST BE COMPLETED IN ORDER TO PROCESS.)

POLICY NO.

DISTRIBUTION OF THIS REPORT

1.ORIGINAL MUST BE SENT IMMEDIATELY TO WORKER’S COMPENSATION INSURANCE CARRIER.

2.COPY TO THE INDUSTRIAL ACCIDENT BOARD

3.EMPLOYER’S COPY - RETAIN AS RECORD

4.EMPLOYEE’S COPY

SIGNATURE OF PERSON IN 14 ABOVE

OFFICIAL POSITION

Document 60 07 02 03 03 01 WC 8388g (5-03) UNIFORM

WORKERS' COMPENSATION

IMPORTANT THINGS TO DO IN CASE OF INJURY

THE EMPLOYER SHOULD:

1.Provide all necessary medical, surgical and hospital treatment from the date of accident.

2.Every employer shall keep a record of all injuries received by employees and make a report within 10 days thereof in writing to the Office of Workers' Compensation.

3.Ascertain the average weekly wages of the employee and provide compensation in accordance with the provisions of the law, for disability beyond the third day after the accident. All agreements as to compensation must be submitted to the Office of Workers' Compensation for approval.

THE EMPLOYEE SHOULD:

1.Immediately notify the employer in writing of accidental injury or occupational disease and request medical services. Failure to give notice or to accept medical services may deprive the employee of the right to compensation.

2.Give promptly to the employer, directly or through a supervisor, notice of any claim for compensation for the period of disability beyond the third day after the accident. In case of fatal injures, notice must be given by one or more dependents of the deceased or by a person on their behalf.

3.In case of failure to reach an agreement with the employer in regard to compensation under the law, file application with the Industrial Accident Board for a hearing on the matters at issue within two years of the date of accidental injury or one year of knowledge of the diagnosis of an occupational disease or an ionizing radiation injury. All forms can be obtained from the Office of Workers' Compensation.

UNIFORM WC 8388g (5-03)

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2. Just after performing the previous step, go on to the subsequent stage and fill out the essential details in these fields - R O Y R U J N, E S A E S D, SPECIFY THE DEPARTMENT WHERE, LIST THE EQUIPMENT MATERIALS AND, E C N E R R U C C O, DESCRIBE THE EMPLOYEES ACTIVITY, DESCRIBE HOW THE INJURYILLNESS, NAME OF PHYSICIAN, HOSPITAL IF APPLICABLE, PHYSICIANS ADDRESS, HOSPITAL ADDRESS, WORKERS COMPENSATION INSURANCE, THIS SECTION MUST BE COMPLETED IN, POLICY NO, and DISTRIBUTION OF THIS REPORT.

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Form Wc 8388G – Fill Out and Use This PDF

Form Wc 8388G PDF Details

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