Workers' Compensation

Reporting a Work Related Injury or Illness

Employees, Volunteers and Student Assistants

Report all injuries and illnesses to the Human Resources Management department within 24 hours of the injury or illness. You may be entitled to workers' compensation benefits if you are injured or become ill because of your job, or as victim of a workplace crime. Workers' compensation covers most work-related physical or mental injuries. If you are injured or ill, notify your supervisor immediately and report to Human Resources Management to complete the necessary forms.

1. Employee/Volunteer Report of Injury/Illness

For all injuries and illnesses, please complete an Employee/Volunteer Report of Injury/Illness form. Complete and sign the "Employee" portion and return it to Human Resources Management.

2. Employees Claim for Workers' Compensation Benefits

If an injury or illness requires more than first aid treatment, Human Resources Management will provide you with an Employee's Claim for Workers' Compensation Benefits form. Complete and sign the "Employee" portion of this form and return it to Human Resources Management.

3. Seek medical treatment if needed

Prior to going for treatment or evaluation, you will need a Medical Service Order. The form authorizes treatment at Western Medical Group. You must receive the signed form from Human Resources Management. This form lets the medical facility know that you are being seen for a work related injury or illness.

Managers and Supervisors

If an injury or illness requires medical treatment beyond first aid, please contact the Human Resources Management department and send the employee to Human Resources Management to complete all necessary forms.