• Workers' Compensation Procedures
    See Policy DEC(LOCAL)

    1. All on the job injuries must be reported immediately to your supervisor at the time of injury.

    2. The Supervisor's Accident Investigation Report must be completed at the time of the injury, preferably by the supervisor. (In some cases, the supervisor's designee can fill out this report, but will need to communicate with the Risk Management department letting us know that you, the supervisor, are aware of the incident)

    The Employee's On the Job Injury Report must be completed as well, preferably by the injured employee. (Only if needed, someone other than the injured employee can fill out this report, but the individual filling out the report will need to print & sign their name – NOT the injured employee's name)

    It's important to report, as soon as possible, any on the job injuries to the Risk Management department so that the processing of all necessary Workers' Compensation paperwork can begin.

    Dependent upon the severity of the injury, the individual filling out the Supervisor's report needs to call in the incident to Evette Bluitt, Coordinator of Risk Management as soon as possible. From there, the documents need to reach the Risk Management department 1 of 3 ways:
    (a) *Fax – in which you will need to call me and confirm receipt of the fax.
    (b) Inter-Campus mail
    (c) Drop Off
    * If faxing is your preferred choice, please send the original forms to me via Inter-Campus mail.

    3. Any lost time due to the injury must be reported immediately to the Coordinator of Risk Management, Evette Bluitt and the Benefits/Leave Specialist in Human Resources. A Doctor's release must be obtained and sent to both the Risk Management and Benefits Departments before returning to work.

    Depending on certain situations, additional documents and forms may be required.

    Noncompliance and/or late filings can cost the district up to $500 per occurrence.

    Evette Bluitt
    Coordinator of Risk Management
    (817) 232-0880, ext 2960
    Fax # (817) 232-0238

    Click here to access the Supervisor's Accident Investigation Report

    Click here to access the Employee's on the Job Injury Report