USI 1201–03: Work-Related Injuries

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Effective: 2/28/1989

Revised: 11/1/2006

USI 1201–03: Employee Work-Related Injuries

Purpose

To provide initial and short-term follow-up care for employees who suffer from a work-related injury or illness

Sources

Office of the Deputy Vice President/University Dean of Student Affairs

Campus Health Service

Policy

Campus Health Service (CHS) will provide short-term or emergency care to employees who become ill or injured while on the job. The CHS will refer employees to a local hospital if extensive or long-term care is required.

Note:

Employees who need non-acute follow-up care will be referred to their private physician, clinic, or other Worker’s Compensation-designated provider.

ProcedureD

Responsibility	Action
Employee	Report the work-related injury or illness to the supervisor.
Supervisor	Direct the employee to Campus Health Service. Complete the Employer’s Report of Industrial Injury form and send it to Human Resources.
Campus Health Service (CHS) Clinician	Provide care. If additional treatment is necessary, refer the employee to his or her private physician, clinic, or Worker’s Compensation-designated provider.
Employee	Schedule follow-up medical care with primary physician or clinic, if necessary.
CHS Clinician	Complete the physician portion of the State of Arizona Worker’s Compensation report (no. 04-0102).
CHS Medical Records	Complete the rest of the no. 04-0102 report. Review and forward the form to Human Resources.
Human Resources	Forward a copy to the State Worker’s Compensation Department.

endtable

Cross-Reference

For complete information about Workers’ Compensation, see the Staff Personnel Policies and Procedures Manual—SPP 504–02, “Workers’ Compensation.”

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