Workers Compensation How-To Information

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The How-To information herein will assist you with commonly used forms for Workers Compensation.


HOW TO INFORMATION


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Description of Employee Job Duties

Who: Staff or Faculty

When: This form is developed jointly by the employer and employee and is intended to describe the employee’s job duties.

How: Complete the form and route to Human Resources.

Form: Description of Employee Job Duties

Related Information:


To find out more, go to: Workers Compensation

Notice of Temporary Modified Duty Template

Who: Staff or Faculty

When: This form is used to document the modified work duties based upon correspondence from employee’s physician, who authorized the release to modified work.

How: Complete the form and route to Human Resources.

Form: Notice of Temporary Modified Duty Template

Related Information:


To find out more, go to: Workers Compensation

Pre-designation of Personal Physician

Who: Staff or Faculty

When: This form is used to notify your employer if you wish to have your personal medical doctor or a doctor of osteopathic medicine treat you for a work- related injury or illness, provided the requirements to do so are met.

How: Complete the form, acquire the appropriate signatures, and route to Human Resources.

Form: Pre-designation of Personal Physician

Related Information:


To find out more, go to: Workers Compensation

Pre-designation of Personal Chiropractor or Acupuncturist

Who: Staff or Faculty

When: This form is used to change your treating physician to your personal chiropractor or acupuncturist following a work-related injury or illness, provided the conditions to do so are met.

How: Complete the form, acquire the appropriate signatures, and route to Human Resources.

Form: Pre-designation of Personal Chiropractor or Acupuncturist

Related Information:


To find out more, go to: Workers Compensation

Supervisor Report of Injury

Who: Ill or Injured Workers Supervisor

When: This form is used to report an employee’s illness or injury Immediately after the injury is known.

How: Complete the form and route to Human Resources.

Form: Supervisor Report of Injury

Related Information:


To find out more, go to: Workers Compensation