Workers' Compensation is system in which the injured worker receives medical and
compensation benefits regardless of the circumstances of the work-related
illness or injury. The university's Workers Compensation benefit is provided through the State of Arizona.
All employees are eligible.
Types of injuries are covered
All work-related injuries or illnesses should
be reported to Human Resources by means of the Supervisor's Report of Industrial Injury (SRI) form.
In the event of a work-related injury,
the employee should comply with this procedure
|Assess||The employee or a co-worker should assess the injury.|
|Notify||The injured employee's supervisor must be notified immediately.|
|Seek|| If necessary an employee may seek medical care |
|Report ||Before the end of shift the supervisor must report the injury|
If you require medical care as a result of a work related injury you may visit:
- Campus Health Services
- A private physician to treat the injury.
In the case of an emergency, you may visit the Flagstaff Medical Center emergency room, or a similar facility.
It is the supervisor’s responsibility to
- Notify the State of Arizona's Early Claims Reporting Service phone line at 1-800-837-858.
- Complete and submit a Supervisor's Report of Industrial Injury (SRI) form to Human Resources the same day the injury occurs.
The university must inform State Risk Management and the Industrial Commission of the injury within ten days after notification.
- Both an Employer's Report of Injury and a Physician's Report of Injury must be submitted.
- When the claim is complete and filed, medical treatment, testing, and compensability can be determined.
- Once the Industrial Commission receives the Physician's Report of Injury, State Risk Management has 21 days to accept or deny the claim.
- If the claim is accepted, the injured worker may be eligible for benefits.
Denial of a claim
If a claim is denied, a protest can be filed with the Industrial Commission. It is the employee's responsibility to understand all notices and documents that allow for hearing requests in the event of disagreements, and it is also the employee's responsibility to make current addresses know to the Industrial Commission and State Risk Management.
If an employee is unable to return to regular duty due to physician's restrictions, the employee may be eligible for light duty assignment.
If the employee requests light duty assignment:
- A Light Duty Request Form must be submitted to the supervisor for consideration, accompanied by a doctor's statement identifying the specified restriction or limitation.
- The supervisor may contact the Human Resources to ask for clarification from the health care provider of the employee's limitations.
- If approved, the Light Duty Request Form is forwarded to Human Resources.
- If not approved, the employee will be put on an off work status and placed on an Industrial Leave for up to six months.
Industrial Leave of Absence
Industrial Leave of Absence may not exceed six months. All requests for Industrial Leave of Absence, or monthly extensions of leave, are subject to the approval of the department head, the dean/director, and the appropriate provost/associate provost or vice president. Requests must be accompanied by a physician's certificate that shows you are still under medical care and you are not able to work.
If your department head has reason to question your capacity to perform duties and responsibilities upon return, the department head may require you to provide a physician's statement certifying that you are able to continue in the performance of regular duties. The university may also choose to get a second opinion through the university workers' compensation insurance carrier.