Section Lab 504.02 - Record Keeping and Filing of Reports(a) Employers shall record work-connected injuries and diseases in sufficient detail and keep same for a period of 5 years from date of injury for future reference. The "Notice of Accidental Injury or Occupational Disease" form 8aWCA (7/2014), contained in Appendix II together with the "Employer's First Report of Injury" form 8WC (12/2014), contained in Appendix II, when satisfactorily completed shall constitute proof of compliance with the foregoing requirement.(b) Employers shall direct injured employees to complete and make available the "Notice of Accidental Injury or Occupational Disease", form 8aWCA (7/2014) contained in Appendix II; as soon as possible with respect to any injury or disease which requires medical attention. Acknowledgment of receipt of such notice shall be given by signing and giving the employee his copy pursuant to RSA 281-A: 19, RSA 281-A: 20.(c) Employers, self-insured or insurance carriers shall complete and file electronically or in writing, to the department, an "Employer's First Report of Injury" form 8WC (12/2014), and simultaneously send that report to the appropriate insurance carrier.(d) "Employer's First Report of Injury" form 8WC (12/2014), contained in Appendix II, shall be completed and filed as soon as possible after gaining knowledge of the work-connected injury or disease, but no later than 5 days thereafter, in accordance with RSA 281-A:53.(e) The filing of the first report shall in no way prejudice the employer's right to contest the compensability of the claim at a later date.(f) The absence of the "Notice of Accidental Injury or Occupational Disease" form 8aWCA (7/2014) contained in Appendix II shall not excuse the employer from complying with these provisions.(g) Unless the employer disputes the compensability or the amount of the bill, for any injury that required only first aid treatment, the employer may choose not to send the first report to the carrier required by (c) if that employer pays the bill within 30 days.(h) If the injury that resulted in first aid treatment requires further treatment or, results in lost time from work, the employer shall notify the carrier of the injury.(i) If an employer fails to file a "First Report of Injury" form 8WC (12/2014), contained in Appendix II, or files the first report of injury form beyond the statutory time frame, a civil penalty of up to $2,500.00 shall be assessed against the employer or their carrier or the agent who was responsible for the transmission of the form pursuant to Lab 508.02.(j) Employers shall complete and file with the department, with a copy sent to carriers nearest claims office, an "Employer's Supplemental Report of Injury", form 13WCA (3/2014), contained in Appendix II; in the following instances: (1) No later than 7 days after the first day of disability if the Employer's First Report of Injury form 8WC (12/2014), contained in Appendix II did not indicate such disability as per RSA 281-A:53;(2) Upon an employee's return to work after a period of compensable disability; should an employee's earnings after a return to work result in a lesser amount than prior to the injury, such information shall be included in the supplemental report; or(3) If the employee has a subsequent period of disability.(k) Employers shall complete and make available to the carrier two copies of the "Wage Schedule", form 76WCA (9/2015) contained in Appendix II or record of gross earnings pursuant to Lab 506.02(b). Employers shall report the weekly wages on the basis of gross wages, including pay for overtime work, vacation pay, commission, and bonuses for the periods to which such payments apply and also including when applicable, the reasonable value of board, rent, housing, lodging, fuel or other similar advantage furnished by the employer as in RSA 281-A: 2, XV, RSA 281-A:15. Employers shall note the reason for weeks of zero earnings.(l) In the event of a claim pursuant to RSA 281-A:15, III, relative to combined earnings, the employee's concurrent employer(s) shall, upon request by the employee, complete and make available the "Wage Schedule" 76WCA (9/2015) contained in Appendix II as prescribed in (k).N.H. Admin. Code § Lab 504.02
#2264, eff 1-6-83; ss by #2935, eff 12-27-84; amd by #4854, eff 6-29-90; amd by #5041, eff 1-9-91; ss by #5235, eff 9-27-91, EXPIRED: 9-27-97
New. #6631, INTERIM, eff 11-16-97, EXPIRED: 3-16-98
New. #6806, eff 7-18-98); ss by #8682, INTERIM, eff 7-15-06, EXPIRED: 1-11-07
New. #9019, eff 11-1-07
Amended by, Volume XXXVI Number 14, Filed April 7, 2016, Proposed by #11067, Effective 4/1/2016, Expires 4/1/2026.The amended version of this section by New Hampshire Register Volume 39, Number 37, eff.8/17/2019 is not yet available.