Reporting A Work-Related Injury
Work-related injuries
should be reported to the University's Workers' Compensation department within one business
day of an accident to preserve your right to benefits.
The required forms (in PDF format) are as follows:
The injured employee is responsible for signing both the Workers' Compensation Information - (Form B) and Employee Acknowledgement - (Form D). The injured employee's supervisor or departmental designee is responsible for completing the two-page Employer's Report of Occupational Injury or Disease - (Forms F and G), Additional
Injury Report Information - (Form H) and for providing copies of Forms B, C and D to the injured employee.
Forms B, D, F, G and H should be faxed to Workers' Compensation at 412-624-1817.
If you require medical treatment, follow the procedures set forth on the Health Care Provider Panel and Procedures - (Form C) for your designated campus.
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