Form 211 Social Security

Work Accident Form, Notice of Injury at Work and Claim for Payment of Injury Compensation

Work Injury form 211 is submitted to recieve injury compensation, by an employee who injured or fell ill during his work. This form represents the initial details relevant to work injury. This form is signed by employee as well as employer, that constitues a confirmation of injury as a result of work accident. It is important to remember, this form can be submitted for work injury whether the injury is physical or mental.

Click Here to Download PDF WOrk Injury Form 211

Filling up work injury form 211 is an essential step in recognation of work injury by National Insurance Institute. Form contails different sections, these sections must be filled carefully, accurately with complete details of incident. All relevant documents, i.e first medical certificate, report of emergancy room, summary of illness from hospital, employees salary documents, witness details and any other document must be attached.

Note: Foreign workers are required to attach a copy of their passport, and Volunteers are required to attach a volunteer card or a referral form.

Form 211 for Car Accidents:

There is a section of work injury form 211 for the victims of a car accident. In this section victim should give details of the notification to the police, details of the driver and passengers, location of accident, and details of vehicle involved. If a claim has been filed with any insurance company, its details must be filled in this section.

It is important to note that work Injury Form 211 itself doesn’t constitue a confirmation of recognition by National Insurance Institute for the accident as work injury.

Submitting form 211 is initial and a very important step in the process of Work Injury recognition, that’s the reason professional lawyer help is always advised. Our professional lawyers team at Deri Law Firm will always be on service to assist you regarding your work injury claim. Deri Law Firm is lead by senior lawyer Adv Oshrat Deri, a former National Inssurance Institue lawyer with over 20 years of experience in work injury law. You get a free initial consultation meeting. Get a free consultation meeting now by clicking here or call us at 035185190.