Free Employee's Claim and Employer First Report of Injury - Vermont

Employee's Claim and Employer First Report of Injury First-Aid Only Injuries and Deductible Policies

21 V.S.A. Title 21, Chapter 9, §640(e) was changed by S.345 in the 2007-08 Legislative Session. The new language is below. (e) In the case of a work-related, first-aid-only injury, the employer shall file the first report of injury with the department of labor. The employer shall file the first report of injury with the workers' compensation insurance carrier or pay the medical bill within 30 days. If the employer contests a claim, a first report of injury shall be forwarded to the department of labor and the insurer within five days of notice. If additional treatment or medical visits are required or if the employee loses more than one day of work, the claim shall be promptly reported to the workers' compensation insurer, which shall adjust the claim. "Work-related, first-aid-only-treatment" means any one-time treatment that generates a bill for less than $750.00 and for which the employee loses no time from work except for the time for medical treatment and recovery not to exceed one day of absence from work.

Please ensure that you have completed box 35 on all Employee's Claim and Employer First Report of Injury.