OMB control number
Employer's First Report of Injury or Occupational Disease; Physician's Report on Impairment of Vision; and Employer's Supplementary Report of Accident or Occupational Illness
OMB 1215-0031 · DOL/ESA.
OMB 1215-0031
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form LS-202 Employer's First Report of Injury or Occupational Disease; Physician's Report on Impairment of Vision; and Employer's Supplementary Report of Accident or Occupational Illness | Form |
 SS for 1215-0031 (LS-202 and LS-210) April 10, 2007.doc | Supporting Statement A |
| DOL-ESA-15.pdf | Supplementary Document |
 Employer's First Report of Injury or Occupational Disease; Physician's Report on Impairment of Vision; and Employer's Supplementary Report of Accident or Occupational Illness |
Form |