Employer Duties Regarding Occupational Injuries or Illnesses

Your Role - After an Injury1. Notify your Supervisor/Director immediately.

• Report all injuries, no matter how minor or temporary they may seem to be.• If you witness an injury that prevents a co-worker from moving or speaking, immediately

inform your supervisor. 2. Employee Injured

• Minor Injury – (Splinter, non-bleeding, non-life threatening ) Non-emergencies –• Major Injury – Visit ER & Urgent Care - Emergencies – call 911 and go to the ER by

ambulance. Examples of emergencies include loss of blood, heart attack, blunt force to the head, severe burns and electric shock.

3. Get triage. • Help the employee determine what kind of care you need by describing your injury.• Triage includes an initial injury report. Fill out Proper form. Return to Supervisor.

4. Seek prompt medical attention. • Give Employee Packet from Blue Folder • In Packet is a list of In-Network Locations• If the employee is admitted to hospital, the IA has 24 hours to report to OSHA.

5. Report the injury. • Employee will turn into you Notice of Accident to Employer and Claim of Employee Form,

NC Form 18 (Using same form for all states). Submit to Supervisor & HR. • Complete the required Workers Compensation paperwork, including the State Form First

Report of Employee Injury, Illness. Make a Copy for your records• Help Safety Committee Fill out OSHA Forms 301.

6. Update Supervisor / Director • Throughout employee recovery, update your supervisor/Director on the employee’s

progress. 7. Return to Work

• Employee will turn into you Return to Work with your doctor signature. Work with employee to find ways to return to work during the recovery process. Turn in any forms Employee gives to you to Supervisor / Director and to HR.

CFAIA Process

49 Pisgah Hwy., Ste 4 Pisgah Forest, North Carolina 28768 (828) 884-5713 Fax: (828) 884-4671www.cfaia.org

IA Role – Injury - Workers Compensation Process 1. Employee Injured

a. Minor Injury – (Splinter, non-bleeding, non-life threatening )

i. Fill out Site Incident Report

ii. Call / Email Direct Supervisor

b. Major Injury – Visit ER & Urgent Care

i. Call 911, Call / Email Direct Supervisor and HR Manager

ii. Give Employee Packet from HR Blue Folder

iii. Fill out Workers Compensation Form / First Report of Injury

2. Human Resources Blue Folder:

a. Employee Duties Letter

b. Proof of Coverage Letter

c. Provider List / Pharmacy Card

d. Workers Comp Cover Letter

e. Notice of Accident to Employer

f. Return to Work Form / Job Description

3. Workers Compensation Adjuster will request and provide their documents

4. HR will fill the claim with Workers Compensation and follow till Claim is closed.

5. Safety Committee to fill out OSHA’s Form 301 Injury and Illness Incident Report (Joint investigation with at least

two members)

a. Verifying Incident and details, Training, Safety Procedures were followed, etc.

6. HR add to IA OSHA’s Form 300 Log

7. All accidents reported to Safety Committee Meeting

a. Quarterly reported to Directors

8. HR fill out OSHA’s Form 300A Annual Summary of Work – Related Injuries and Illness

49 Pisgah Hwy., Ste 4 Pisgah Forest, North Carolina 28768 (828) 884-5713 Fax: (828) 884-4671www.cfaia.org