Form 110 is for claims of injury or death benefits by employees. Employers must carry valid workers' compensation insurance. Claims must be filed with DIA, employer, and insurer. Self-representation (PRO SE) is allowed but not mandatory
Document recording workplace illnesses, injuries, near misses and accidents. Required at time of incident, regardless of severity. Must include date, time, location, description and witness information
Lost time injury is any job-related injury preventing one day/shift work. LTIFR is calculated per 1 million man-hours worked. Formula: (Number of injuries x 1,000,000) / Total hours worked
Workplace accident is unexpected event causing physical or mental harm during work. Main causes include negligence, inadequate training, safety equipment, and human error. Fatigue, stress, and poor communication can contribute to accidents
LTI is an injury causing fatality, permanent disability or lost work time. Only injuries occurring on the job count towards LTI metrics. Lost time can range from one day to permanent disability
FIM measures disability severity and basic life activity assistance. WeeFIM is pediatric version of FIM with developmental stage considerations. Both instruments used for Lifetime Care and Workers Care eligibility