Workplace Injury
When an employee is injured on the job, the employee has a responsibility to report the injury to his/her supervisor, HR Generalist, or the District Administrative Assistant. Under Risk Management guidelines, the “First Report of Injury” should be filed with Workers Comp within seven days of the date of injury.
Seek medical attention (if necessary): Workers Compensation Fund has provided a list of Preferred Providers, please seek medical attention at one of these locations if at all possible.
Workplace Injury - What now?
If the injury is an emergency, please seek medical attention at one of the Preferred Providers if at all possible.
When employees are seen at a preferred provider WorkMed facility, we are confident that the proper treatment is performed, employees are promptly returned to work even if they have been given restrictions, and our medical costs are lower because WCF Insurance has a contract in place for lower prices.
If the injured employee needs medical attention, then they must complete & submit the Incident Report Form and Form 122 (see below) to the appropriate HR Generalist or District Administrative Assistant as soon as possible but no later than seven days of the date of injury. Note: Please do not submit a claim directly to WCF. WCF requires claims to be submitted by the HR Department only.
If the injured employee does not need medical attention and does not seek medical attention, then they must complete the Incident Report Form and return it to the appropriate HR Generalist or District Administrative Assistant as soon as possible. Note: Please do not submit a claim directly to WCF. WCF requires claims to be submitted by the HR Department only.
An employee who sought medical attention will receive the official copy of their submitted claim by mail and email. A probationer will receive the official copy by mail only.
Incident Report Form.pdfIncident Report Form
The Incident Report Form must be completed for a workplace injury, whether the employee seeks medical attention or not. The employee or supervisor should complete this form and submit it to the appropriate HR Generalist or District Administrative Assistant.
Form 122.pdfForm 122 - Employer's First Report of Injury or Illness
Form 122 must be completed when an employee seeks medical attention for a workplace injury. The employee or supervisor should complete this form and submit it to the appropriate HR Generalist or District Administrative Assistant.
Frequently Asked Questions
What should I do if a probationer is injured while on work crew? Probationers are covered by Workers Compensation. The process outlined above also applies to probationers. The probationer, probation staff, or the parent/guardian would complete Form 122 if medical treatment is needed.
Where should I seek treatment if a WorkMed location is not available, or if an injury occurs after normal business hours? If an injury occurs after normal business hours and is not life- or limb-threatening, the Intermountain Medical Group has several locations available to assist your injured employee. For a listing of the after hours clinics, please visit Intermountain Healthcare. This site provides a list of convenient locations and office hours by city or zip code.
What does Workers Compensation cover? The date of injury is not covered by Workers Compensation no matter what time the injury occurred, even if it is one minute after shift starts or walking into the building to get to work. After the date of injury, there is a three day waiting period, unless they are off of work for 15 calendar days or more. If the date of injury was 11/1/21, the three day waiting period would be 11/2, 11/3, and 11/4. Workers Compensation would not pay for these days unless the employee was off of work for 15 days or more. For example, if the date of injury was on 11/1 and the employee went back to work on 11/16 or any day prior to 11/16, Workers Compensation would not pay for the 3 day waiting period. However, if the employee was off of work and didn’t return until 11/17 or later, Workers Compensation would pay starting the day after the injury. Typically, the employee will use their own leave while waiting for approval from Workers Compensation. If the claim is approved, the employee can “buy back” eligible hours. The three day waiting period is only eligible for “buy back” if the employee is off of work for 15 or more calendar days. The employee can also choose to go into a “Leave without Pay – Industrial” status.
Workers Compensation Checks