Sample Letter Reporting Your Industrial Accident and Work-Related Injuries to Your Employer


Learn What to Include in Your Letter Reporting Your Work Accident and Workplace Injuries to the Employer


The pursuit of workers’ compensation benefits starts before you file a workers’ compensation claim. Even if you file a claim within the applicable statute of limitations, you must still have reported your work injuries to your employer in a timely fashion – or else you may be barred from receiving compensation and medical benefits.


Below is a sample letter you can give to your employer to satisfy the legal requirements regarding notice under Virginia workers’ compensation. Make sure you keep a copy of the letter for your own records and for your workers compensation lawyer, in case the employer and its insurance carrier dispute your claim.


Letter Reporting Your Work Accident and Injuries



Name of Supervisor
Employer Name


Dear (Name of Supervisor) :


Please accept this letter as written notice that on (date) at (time) I was involved in the following work accident (give details). Immediately after the accident, I spoke with (name of person with whom you spoke) and (what happened post-accident, including medical treatment if you have obtained it). I am in the process of having my injuries evaluated. Based on my treatment regimen thus far, it is my understanding that I suffered the following injuries: (list injuries). I have received the following restrictions (list restrictions) from (doctor’s name).


I would appreciate it if you would provide a panel of physicians with whom I may treat. Due to uncertainties regarding my recovery and the type of treatment I may require in the future, it will be necessary for me to file a workers’ compensation claim. Please let me know the best way for me to file a claim with your workers’ compensation insurance carrier.


Thanks for your assistance. If you need any information fro me or wish to speak with me regarding the accident, my injuries, and my restrictions, contact me at your convenience. I look forward to working with you through this time.




(Your name)


Contact An Experienced Workers Comp Attorney Who Can Help You Notify Your Employer of Your Injuries and Win Your Case


The workers compensation claims process can be long and frustrating. Even if the employer or its insurer accept responsibility for the accident and injuries, many other issues can arise at any time: authorization of medical care; a late check; a dispute over the pre-injury average weekly wage; a dispute over whether light duty employment is within your work restrictions; the nurse case manager pressuring your doctor to release you back to work before you’re ready; and, much more. This is why it’s in your best interest to hire an attorney right away.


Corey Pollard has helped hundreds of injured workers and their families in Richmond, Newport News, Hampton, Williamsburg, Norfolk, Chesapeake, Virginia Beach, and surrounding areas following an industrial accident. Call, text, or email us today for a free strategy session. We’re here to help you get the wage loss benefits, permanent partial disability compensation, medical care, and lump sum workers compensation settlement you deserve.


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