1. If an employee suffers an on-the-job injury, the employee's supervisor must be notified immediately. The supervisor will assess the nature and extent of the injury. All medical care provided to the employee will be selected and approved by the University of North Carolina at Pembroke. If the injury is serious and requires immediate medical attention, the supervisor will arrange for the transport of the employee to a hospital or other appropriate medical care. Less serious injuries that require medical attention will be directed by the supervisor to an approved medical provider. First aid cases may be directed to an approved physician's office, the University Infirmary, or treated in the department, depending on the nature and extent of injury.
2. As soon as is feasible at the time of injury, the employee should complete North Carolina Industrial Commission Form 18, Notice of Accident to Employer. Copies of this form are available in each respective department or in the Human Resources Department.
These forms should be completed and forwarded immediately to the Human Resources Office. If off-campus medical care is provided, the supervisor should complete Section 1 of the Medical Authorization and Attending Physician's Report (copy follows policy) and provide this form to the injured employee who will take it to the attending physician's office where it will be completed. This form will be used to verify the initial treatment authorization as well.
3. If there is a question as to the University's liability or to the circumstances surrounding a reported injury, the supervisor should conduct a thorough investigation of the events surrounding the injury. The supervisor may also discuss the injury with the department head or the University Safety Officer. If a claim for Workers' Compensation is to be denied, the supervisor should notify the Human Resources Department and the employee.
4. After medical treatment is provided to the employee, the injured employee and/or his/her representative should return the Medical Authorization and Attending Physician's Report to the supervisor on the day of treatment. Approved physician offices will be aware of the necessity to complete the paperwork in a timely manner and will be prepared to do so. If an employee is returned to work with restrictions, alternate duty work will be made available to the employee whenever possible. Priority for alternate duty work will be first to return the employee to the employing department, secondly to the employing division, and thirdly to return the employee to work in another University division.
5. If the employee is unable to return to work, the Human Resources Department will consider the case for referral to a third party administrator for rehabilitative case management. Ongoing medical care for the injured employee will be coordinated by the Human Resources department and the designated Case Manager until the employee is released to return to work
- Workers' Compensation Forms: