The form has an Employer section with name, contact person, job title, position, phone number and prepared by.
Job description: what is the purpose and objective of this job?
Equipment: list equipment, machines, tools, vehicles used and special considerations (environmental conditions, vision, hearing, height).
Questions: contact the State Board of Workers' Compensation at 404-656-3818 or 1-800-533-0682.
| Question | Answer |
|---|---|
| Form Name | WC-240a |
| Form Length | 2 pages |
| Fillable? | Yes |
| Fillable fields | 242 |
| Avg. time to fill out | 41 min |
| Edition | Rev 12/2018 |
| Issuing agency | Georgia State Board of Workers' Compensation |
| Attach to | A WC-240 |
| Matches the agency's file | Yes, checked October 3, 2026 |
| Other names | WC-240a, WC 240a, WC240a, Job Analysis, Georgia job analysis, WC-240 attachment |
| Official source | WC-240a (Rev 12/2018), Georgia State Board of Workers' Compensation |
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