The Telegraph-courier. [volume] (Kenosha, Wis.) 1888-1946, 1911-08-03
TWO REPORTS MUST Be MADE
Employer Will be Given Chance to
Make Suggestions as to the Amount
Of Compensation to be Paid to the
Injured Workmen.

While the Kenosha manufacturers
and other employers of the city have
not all filed with the industrial acct
dent board their acceptances of the
new compensation law all Of the en-
ployers of labor in the city this morn
ing received from the board copies of
the blanks to be used in making the
report of accidents and it is probable
that the greater part of the manufact-
urers will at once begin the settlement
of claims for injuries through the state
board. There are two blanks sent to
the employers at this time and under
the rules Of the board these blanks
must be used in making reports of all
injuries IN which compensation may be
claimed by the workmen. These have
not only been sent to the employers of
labor, but a supply has been sent to
the county clerk in order that he may
be able to supply them in any cases
where an employer of labor was over
looked by the state board.
There are two blanks which must be
filled out by the employer following the
inquiry of any of his workmen. The
first blank must be forwarded to the
board within five days after the acct
dent occurs. This blank must give all
possible facts in regard to the acci-
dent. This information includes the
name, postofice address of the employer
and the employed. The occupation of
the employee, the sex, age, color and
nationality and in case death results
from accident the employer must give
the names Of all people dependent upon
the man SO killed. This must be fol
lowed with the relationship each de-
pendent bears and his or her age. The
date and place of the accident must be
given and the employer is expected to
state as far as possible the cause of
the accident. He must show the nature
and extent of all injuries and the temp
orary result of them together with a
statement of the probable duration of
the injury in months and days. The
employer is also asked to guess wheth-
er or not the accident will result in
the permanent injury of the employee
In addition he must give the name and
address of attending physicians, the
nature of temporary relief given to
the injured party and the proposed re-
Lief. This will give the employer a
chance to suggest what in his judg-
ment would be fair compensation for
an injured workman.
The second blank must be filed out
and fled with the board within fifteen
days after the accident. This blank
is largely a repetition of the former
blank save that it provides that rec
ord of the condition Of the injured
party be given. In this report the en-
Pioyo iiooo oe"CS any ooCbAoAcAG IAdb
has been made and the terms of any
agreement for settlement.
There are no blanks to be filled out
and filed by the injured party, but if
he so desires he may send to the board
statement which will be used by the
board in checking up the statements
made by his employer. The board will
have direct charge of the settlement of
all claims and before adjustments are
made members of the board or agents
will be sent to make personal ex-
animation into the accident and the
conditions surrounding it.