This is not an insurance form, but rather a method of keeping an internal record by your dire districts of all accidents. This form should be completed after and accident and held with the district. If a claim for benefits is made at a later date, this form should be submitted with that claim.
Note: If a firefighter is exposed to a hazardous substance or a hazardous liquid (i.e., A.I.D.S. or asbestos) and no medical bills result out of that exposure, but the firefighter would like to have it on record, complete a VF-1, have an official initial it and keep it on file for future reference. (You may also wish to give a copy of that form to the injured party.) It is not required to forward the form to the insurance company.
Report of Accident or Injury. In addition to completing a VF-1, the following forms may be necessary. Please report all claims by filing the applicable forms with FDM and the New York State Worker's Compensation Board. Be sure that all forms are signed by an authorized representative.