LINN-BENTON COMMUNITY CCOLLEGE

INJURED EMPLOYEE RESPONSIBILITIES CHECKLIST

It is the policy of LBCC to return all employees to available and suitable work as soon as possible.

I. When a work-related injury requires medical attention from a physician and/or results in work time lost:

A. The injured worker immediately contacts his/her direct supervisor (or the next available supervisory person if the direct supervisor is unavailable) prior to leaving his/her work site.

B. If either medical attention or time off from work is necessary, an 801 form must be completed at the Human Resources Office within five (5) days of the date of injury or first knowledge of injury by the supervisor. When there is a "time loss injury," Human Resources will assist the worker's immediate supervisor and the doctor of record to establish a plan for the injured worker's return to work. All original documents from the physician should be forwarded to Human Resources to be placed in the employee's medical file.

C. The injured worker is responsible for informing the attending doctor that a modified work plan is available to them.

D. The injured worker on "time loss" is responsible to keep his/her supervisor informed regarding the extent of the injury and the necessary time loss from work, if any.

E. The injured worker will report the physician's findings within 24 hours to his/her supervisor after each visit or treatment . The supervisor will subsequently keep Human Resources aware of any changes to the modified work progress.

II. When a work-related injury does not require medical attention from a physician and/or result in work time lost:

A. The injured worker contacts his/her immediate supervisor.

B. A General Accident Report form (available from Security and Safety Services) is completed. The original is sent to Security and Safety Services with a copy being maintained in the department.

III. When there is a non-work related injury (general student population/public):

Upon notification of an injury, a College representative will process a General Accident Report form and/or direct the individual to Security and Safety Services.

January 1997