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 Printer-Friendly Version
An employee injured in the performance of his duty, or someone on his
behalf, shall give notice thereof. Notice of a death believed to be
related to the employment shall be given by an eligible beneficiary
specified in section 8133 of this title, or someone on his behalf. A
notice of injury or death shall--
(a) be given within 30 days after the injury or death;
(b) be given to the immediate superior of the employee by personal
delivery or by depositing it in the mail properly stamped and addressed;
(c) be in writing;
(d) state the name and address of the employee;
(e) state the year, month, day, and hour when and the particular
locality where the injury or death occurred;
(f) state the cause and nature of the injury, or, in the case of death,
the employment factors believed to be the cause; and
(g) be signed by and contain the address of the individual giving the
notice.
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