Form 201 Notice of Employee's Injury or Death

Form 201 Notice of Employee's Injury or Death

What Is Form 201?

This is a legal form that was released by the U.S. Department of Labor on April 1, 2009 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form 201?
A: Form 201 is a Notice of Employee's Injury or Death form.

Q: When should Form 201 be used?
A: Form 201 should be used when an employee is injured or dies on the job.

Q: Who needs to fill out Form 201?
A: The employer or the employer's representative needs to fill out Form 201.

Q: What information is required on Form 201?
A: Form 201 requires information such as the employee's name, date of injury or death, and description of the incident.

Q: Is Form 201 mandatory?
A: Yes, Form 201 is mandatory for reporting work-related injuries or deaths.

Q: Are there any deadlines for submitting Form 201?
A: Yes, there are specific deadlines for submitting Form 201. Please check with your state's workers' compensation board for the deadlines.

Q: What should an employee do if they are injured on the job?
A: An employee should inform their employer of the injury as soon as possible and seek necessary medical attention.

Q: What should an employer do if an employee is injured on the job?
A: An employer should provide the employee with the necessary forms, including Form 201, and assist them in reporting the injury to the workers' compensation board.

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Form Details:

  • Released on April 1, 2009;
  • The latest available edition released by the U.S. Department of Labor;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form 201 by clicking the link below or browse more documents and templates provided by the U.S. Department of Labor.

Download Form 201 Notice of Employee's Injury or Death

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