# 20 C.F.R. § 702.202 (2026): Employer's report; form and contents

> Federal · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_202

## Section

- **Citation:** 20 C.F.R. § 702.202 (2026)
- **Heading:** Employer's report; form and contents
- **Jurisdiction:** Federal
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Title 20 CFR: Employees' Benefits / Chapter VI: OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR / Part 702: ADMINISTRATION AND PROCEDURE / Subpart B: Claims Procedures / § 702.202: § 702.202   Employer's report › form and contents.

## Text

The employer's report of an employee's injury or death shall be in writing and on a form prescribed by the Director for this purpose, and shall contain:
(a) The name, address and business of the employer;
(b) The name, address, occupation and Social Security Number (SSN) of the employee;
(c) The cause, nature, and other relevant circumstances of the injury or death;
(d) The year, month, day, and hour when, and the particular locality where, the injury or death occurred;
(e) Such other information as the Director may require.
(Approved by the Office of Management and Budget under control numbers 1215-0031 and 1215-0063)
[58 FR 68032, Dec. 23, 1993]

## Nearby sections

- [20 C.F.R. § 702.201 (2026) § 702.201   Reports from employers of employee's injury or death.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_201.md)
- [20 C.F.R. § 702.202 (2026) § 702.202   Employer's report; form and contents.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_202.md)
- [20 C.F.R. § 702.203 (2026) § 702.203   Employer's report; how given.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_203.md)
- [20 C.F.R. § 702.204 (2026) § 702.204   Employer's report; penalty for failure to furnish and or falsifying.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_204.md)
- [20 C.F.R. § 702.205 (2026) § 702.205   Employer's report; effect of failure to report upon time limitations.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_205.md)
- [20 C.F.R. § 702.211 (2026) § 702.211   Notice of employee's injury or death; designation of responsible official.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_211.md)
- [20 C.F.R. § 702.212 (2026) § 702.212   Notice; when given; when given for certain occupational diseases.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_212.md)
- [20 C.F.R. § 702.213 (2026) § 702.213   Notice; by whom given.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_213.md)
- [20 C.F.R. § 702.214 (2026) § 702.214   Notice; form and content.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_214.md)
- [20 C.F.R. § 702.215 (2026) § 702.215   Notice; how given.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_215.md)
- [20 C.F.R. § 702.216 (2026) § 702.216   Effect of failure to give notice.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_216.md)
- [20 C.F.R. § 702.217 (2026) § 702.217   Penalty for false statement, misrepresentation.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_217.md)
- [20 C.F.R. § 702.221 (2026) § 702.221   Claims for compensation; time limitations.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_221.md)
- [20 C.F.R. § 702.222 (2026) § 702.222   Claims; exceptions to time limitations.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_222.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_202. Check the current official text before relying on it. Not legal advice.