Work-Related Illness or Injury
Worker’s Compensation insurance is provided through the State of Arizona for employees who experience and work-related illness or injury. If approved, this coverage provides medical and income replacement to employees injured on the job regardless of the circumstances of the illness or injury.
Reporting a work- related illness or injury
Both the employee and the supervisor have responsibilities in reporting a work-related illness or injury.
If not life or limb threatening, you should:
- Report the injury/illness to your supervisor immediately.
- Call the Employee Injury Call Center at 800-685-2877 to report the incident and speak with a registered nurse.
- Identify your employer as The State of Arizona.
- Use the Agency Code of 416 for Northern Arizona University.
The nurse will:
- Determine if immediate care is needed.
- connect the employee with the appropriate level of care.
- schedule a referral for further intervention if needed.
- Follow-up with the employee on the next day to see how they are doing.
The nurse will need to gather the important information from you. Below are the types of questions you will be asked.
- Date and Time of call
- Time Zone of Caller
- Name of the person calling
- Location: 416- Northern Arizona University
- City: Flagstaff
- State: AZ
- Zip Code: 86011
- Supervisor’s name
- Supervisor’s Phone Number
- Employee’s name
- Employee’s Job Title
- Employee’s Phone Number
- ID# – your social security number
- Date of birth
- Did the injury happen at work?
- When did it happen? Date and Time of Incident
- Where are you injured? Injured Body Part & Injury Type
- What happened?
A copy of this report will be sent to the Worker’s Compensation carrier and to Human Resources for follow-up.
Within 24 hours of when an employee notifies you of a work-related illness or injury, you should complete the Report of Injury (ROI) form through Louie Department Self Service.
- Sign on to LOUIE:
- On the HR Home Page Select ‘Manage Department Dashboard’
- Select ‘Manage eForms’
- Select ‘Report of Injury Home Page’
- Select ’Create a Report of Injury’
- Click on the ‘Work Related Injury Radio Button’
- Click ‘Next’
- Enter the requested information on each page and then click ‘Next’
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 known to the Industrial Commission and State Risk Management.
Still have questions??
Contact the Benefits Team at firstname.lastname@example.org or call (928) 523-2223.