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ILLINOIS FORM 45: EMPLOYER'S FIRST REPORT OF INJURY Please type or print. Please send this form to: ILLINOIS WORKERS' COMPENSATION COMMISSION 4500 S. SIXTH ST. FRONTAGE RD SPRINGFIELD, IL 62703. By law, employers must keep accurate records of all work-related injuries and illness (except for certain minor injuries).
By law, employers must keep accurate records of all work-related injuries and illness (except for certain minor injuries). Employers shall report to the Commission all injuries resulting in the loss of more than three scheduled workdays.
First reports on fatal accidents are due within two work days after the death; reports on nonfatal cases shall be reported within the month. A supplementary or subsequent report should be made if it is determined that a permanent disability is involved.
Please send this form to: ILLINOIS WORKERS’ COMPENSATION COMMISSION 4500 S. SIXTH ST. FRONTAGE ROAD, SPRINGFIELD, IL 62703-5118. By law, employers must keep accurate records of all work-related injuries and illness (except for certain minor injuries).
Illinois First Report Form 45 – Fill Out and Use This PDF. The Illinois First Report 45 form is a crucial document designed to help employers in Illinois accurately report work-related injuries or illnesses that result in more than three lost workdays.
By law, employers must keep accurate records of all work-related injuries and illness (except for certain minor injuries). Employers shall report to the Commission all injuries resulting in the loss of more than three scheduled workdays.
What was the injury or illness? List the part of body affected and explain how it was affected. What object or substance, if any, directly harmed the employee:
