Complaint Of Alleged Safety Or Health Discrimination | Pdf Fpdf Docx | Kentucky

 Kentucky   Workers Comp 
Complaint Of Alleged Safety Or Health Discrimination | Pdf Fpdf Docx | Kentucky

Last updated: 9/25/2025

Complaint Of Alleged Safety Or Health Discrimination

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Description

COMPLAINT OF ALLEGED SAFETY OR HEALTH DISCRIMINATION. This form is issued by the Kentucky Education and Labor Cabinet, Department of Workplace Standards, Division of Occupational Safety and Health Compliance. It allows employees (or their representatives) to file a complaint if they believe they have been discharged, disciplined, or otherwise discriminated against for engaging in protected safety or health activities under KRS 338.121. Examples of protected activities include filing a workplace safety complaint, participating in an investigation, or exercising rights provided by occupational safety laws. The form gathers complainant and employer information, details of the safety/health complaint, dates of alleged retaliation, witnesses, and reasons for believing discrimination occurred. www.FormsWorkflow.com

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