Workers' Compensation Accident Report Form
Complete the Accident 和 Injury Report within two days of the accident 和 email to benefits@media2work.net
Immediately Notify Supervisor
When an employee has an at-work or work related accident the employee should immediately notify their supervisor. This initial notification should be made:
- 之前 the employee seeks medical treatment (except for injuries requiring emergency medical treatment), 和
- even if the employee does not anticipate needing medical treatment
File Report within 2 Days
At the time the employee notifies their supervisor of the accident, the supervisor provides the employee with a Workers' Compensation Employee Accident/Injury Report. The employee completes the two-page Accident/Injury Report which is reviewed 和 signed by the supervisor 和 forwarded to the Human 资源 好处 Office (benefits@media2work.net) within two days of the accident.
Supervisor Responsibilities
The injured employee's supervisor should keep Human 资源 informed of the employee's status (medical condition, scheduled appointments, work restrictions, lost time etc...).
Workers Compensation 离开
Absences for medical appointments 和 lost time that are the result of the accident should be reported as Workers' Compensation 离开 (WCL). A note from the medical provider is required for each absence.