REQUIREMENTS TO PROCESS ON THE JOB INJURY-Public PPT
1. S 1/8
REQUIREMENTS TO PROCESS
ON THE JOB
INJURY/COMPENSATION CASES
Instruct employee to complete on the job
injury form, “Employee’s Section,” and sign
Differential Application section.
Supervisor completes the “Department
Section” and “Investigation Form,” page 2.
Complete the “Telephonic Employee Accident
Reporting Script.”
2. S 2/8
REQUIREMENTS TO PROCESS
ON THE JOB
INJURY/COMPENSATION CASES
Call the “Employee Accident Reporting Unit,”
using the script you previously filled out.
Receive the Accident Report Number.
Use this number as the Telephonic Control #
If Waiver & Election is requested, then
complete the Waiver & Election Form.
3. S 3/8
REQUIREMENTS TO PROCESS
ON THE JOB
INJURY/COMPENSATION CASES
Fax both sides of completed forms to:
Workers’ Compensation
Accident Reporting Unit
Department of Subways Accident Reporting
System Safety
HR Safety Director
OEVP
4. S 4/8
REQUIREMENTS TO PROCESS
ON THE JOB
INJURY/COMPENSATION CASES
Copies and Original
Send original to
Workers’ Compensation
Send copy to
Accident Reporting Unit
Employee gets a copy
You keep a copy
5. S 5/8
REQUIREMENTS TO PROCESS
ON THE JOB
INJURY/COMPENSATION CASES
Give to Employee:
Workers’ Compensation Injury/Illness on Duty
Instruction Sheet.
Workers’ Compensation “Statement of Rights”
Workers’ Compensation “Injury on Duty Medical
Form.”
6. S 6/8
REQUIREMENTS TO PROCESS
ON THE JOB
INJURY/COMPENSATION CASES
If employee is able to perform duties
Employee is required to return to work.
If employee is unable to perform duties
Employee is advised to seek medical treatment
and evaluation from physician of his/her choice.
7. S 7/8
REQUIREMENTS TO PROCESS
ON THE JOB
INJURY/COMPENSATION CASES
Employee is required to submit timely and
acceptable medical documentation.
If an employee leaves work due to on the job
injury, any time off must be charged to “Injury
On Duty.”
Employee reporting on the job injury may be
sent for drug/alcohol testing in accordance
with existing policies.
8. S 8/8
REQUIREMENTS TO PROCESS
ON THE JOB
INJURY/COMPENSATION CASES
After the accident, next business day.
Set up meeting with Kevin Hyland.
Immediate supervisor of injured and Division head
are to attend.
