Workers Compensation

What to do when if an employee is injured on the job? 

If an injured worker suffers from a workplace injury, accident, or illness, the injured worker may be eligible for Workers’ Compensation benefits.  The injured worker must immediately notify their supervisor and HR within 15 days of the accident or injury. Complete the Workers Compensation (WC) packet as soon as possible and submit to the HR Benefits Office. Seek medical treatment if necessary. 

Complete the following forms: 

• Notice of Accident form (NOA-2) (page 1 – completed by injured employee w/ Supervisor signature/date)
• Employer’s First Report of Injury or Illness (page 2 - Employee/Supervisor) 
• Workers Compensation Basic Information form (page 3 - Employee)
• Workers Compensation Payroll Release form (page 4 – Employee)
• Workers Authorization for Use & Disclosure of Health Records (page 5 - Employee)
• Supervisor Incident Investigation Report (page 6 - Supervisor)
• Supervisor’s Workers Compensation Questionnaire (page 7 - Supervisor)
• Provider’s Report of Physical Ability to be completed by Health Care Provider & Prescription (page 8 - Health Care Provider)

EMERGENCY SITUATIONS: 

CCSD employees should NOT transport the injured worker. 

1. Seek medical treatment at any medical facility of your choosing which accepts NM Workers compensation insurance. CCSD cannot recommend direct care.
2. Notify medical personnel it is a WC injury. Do not use personal insurance.

NON-EMERGENCY or DURING REGULAR BUSINESS HOUR SITUATIONS: 

1. Employee may seek medical treatment at any medical facility of your choosing which accepts NM Workers Compensation insurance. CCSD cannot recommend direct care.
2. Notify medical personnel it is WC injury. Do not use personal insurance.

** Employee must submit to their supervisor and to the HR Benefits office a physician note explaining medical status and/or work restrictions prior to returning to work.  These documents must be given to HR upon receipt.