Work-Related Injuries

If a work-related illness or injury is not life or limb threatening then the employee should:

1. Report the injury/illness to their supervisor immediately.
2. The employee must call 800-685-2877 to speak with a Registered Nurse at the State of Arizona Workers’ Compensation’s Employee Injury Call Center.
3. You should identify your employer as The State of Arizona. After the employer is understood, the Agency Code 416 may be given, which will draw their attention to Northern Arizona University and the services available here on campus.
4. Important: There is no change in the emergency process. If an employee has work-related illness or injury that is life or limb threatening the employee or supervisor will call 911.

• All injured employees MUST call the Employee Injury Call Center at 800-685-2877.
• Calls can be made 24 hours a day/7 days a week.
• The employee will be connected with a registered nurse to evaluate the nature of the workplace incident or injury.
• The nurse will:  
  • Focus on early intervention and the needs of the employee to determine if immediate care is needed.
  • Connect the employee with the appropriate level of care
  • Schedule a referral for further intervention
  • Follow-up with the employee on the next day to see how they are doing
• The nurse will gather the important information from you.  Below are the types of questions you will be asked.
• A copy of this report will be sent to the Worker’s Compensation carrier and to Human Resources for follow-up.
• Review the Workers’ compensation for the State of Arizona Employees Brochure “What you need to know”

Sample questions the nurse may ask:

If an employee slips and falls on the ice, use the Report of Injury to report the incident.  The claim will be processed according to the information and all relevant details about the case.  If you have any questions about when to use the  Report of Injury vs the Third Party report, please contact Human Resources.

Human Resources 925-523-2223

Once a supervisor is notified of an employee’s work related illness or injury the supervisor should submit a report to Human Resources within 24 hours by means of the online Report of Injury(ROI) form.

The online Report of Injury (ROI) is available through Louie Department Self Service.

• Sign on to LOUIE
• Select Department Self Service
•  Select Report of Injury Home Page
• Choose Create a Report of Injury

Instructions on completing the Report of Injury can be found here.

If the work related illness or injury results in an inpatient hospitalization of one or more employees the supervisor should notify human resources immediately at (928)523-2223.

Detailed claim process

• 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.

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 known to the Industrial Commission and State Risk Management.

Light duty

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:

1. 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.
2. The supervisor may contact the Human Resources to ask for clarification from the health care provider of the employee’s limitations.
3. 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 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.