Both the employee and the supervisor have responsibilities in reporting a work-related illness or injury.<\/p>\n
Employee\u00a0<\/strong>Responsibilities<\/h4>\nIf not life or limb threatening, you should:<\/p>\n
\n- Report the injury\/illness to your supervisor immediately.<\/li>\n
- Call the Employee Injury Call Center at 800-685-2877 to report the incident and speak with a registered nurse.\n
\n- Identify your employer as The State of Arizona<\/strong>.<\/li>\n
- Use the Agency Code of 416 for <\/strong>Northern Arizona University.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n
\n\n\n \n![\"Image](\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/5\/2021\/11\/3857-1-Wallet-card-464x348.jpg\")
\n<\/div>\n\n
\n \nThe nurse will:<\/strong><\/p>\n\n- Determine if immediate care is needed.<\/li>\n
- connect the employee with the appropriate level of care.<\/li>\n
- schedule a referral for further intervention if needed.<\/li>\n
- Follow-up with the employee on the next day to see how they are doing. \n<\/div>\n<\/div><\/li>\n<\/ul>\n
\nThe nurse will need to gather the important information from you.\u00a0 Below are the types of questions you will be asked.
\n\n Call Information<\/strong><\/p>\n\n- Date and Time of call<\/li>\n
- Time Zone of Caller<\/li>\n
- Name of the person calling<\/li>\n<\/ul>\n
Employer Information<\/strong><\/p>\n\n- Location:\u00a0416- Northern Arizona University<\/strong><\/li>\n
- City:\u00a0Flagstaff<\/strong><\/li>\n
- State:\u00a0AZ<\/strong><\/li>\n
- Zip Code:\u00a086011<\/strong><\/li>\n
- Supervisor\u2019s name<\/li>\n
- Supervisor\u2019s Phone Number<\/li>\n<\/ul>\n\n<\/div>\n\n\n \n
Incident\/Employee Information<\/strong><\/p>\n\n- Employee\u2019s name<\/li>\n
- Employee\u2019s Job Title<\/li>\n
- Employee\u2019s Phone Number<\/li>\n
- ID# – your social security number<\/li>\n
- Date of birth<\/li>\n
- Did the injury happen at work?<\/li>\n
- When did it happen? Date and Time of Incident<\/li>\n
- Where are you injured? Injured Body Part & Injury Type<\/li>\n
- What happened?<\/li>\n<\/ul>\n\n<\/div>\n<\/div>\n
A copy of this report will be sent to the Worker’s Compensation carrier and to Human Resources for follow-up.<\/p>\n
Review the Workers’ compensation for the State of Arizona Employees Brochure “What you need to know”<\/a><\/p>\nSupervisor Responsibilities<\/strong><\/h4>\nWithin 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\u00a0 LOUIE – HR.<\/strong><\/a><\/p>\n
- \n
- Identify your employer as The State of Arizona<\/strong>.<\/li>\n
- Use the Agency Code of 416 for <\/strong>Northern Arizona University.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n
\n\n\n \n\n<\/div>\n\n\n \nThe nurse will:<\/strong><\/p>\n
- \n
- Determine if immediate care is needed.<\/li>\n
- connect the employee with the appropriate level of care.<\/li>\n
- schedule a referral for further intervention if needed.<\/li>\n
- Follow-up with the employee on the next day to see how they are doing. \n<\/div>\n<\/div><\/li>\n<\/ul>\n
\nThe nurse will need to gather the important information from you.\u00a0 Below are the types of questions you will be asked.
\n\n Call Information<\/strong><\/p>\n- \n
- Date and Time of call<\/li>\n
- Time Zone of Caller<\/li>\n
- Name of the person calling<\/li>\n<\/ul>\n
Employer Information<\/strong><\/p>\n
- \n
- Location:\u00a0416- Northern Arizona University<\/strong><\/li>\n
- City:\u00a0Flagstaff<\/strong><\/li>\n
- State:\u00a0AZ<\/strong><\/li>\n
- Zip Code:\u00a086011<\/strong><\/li>\n
- Supervisor\u2019s name<\/li>\n
- Supervisor\u2019s Phone Number<\/li>\n<\/ul>\n\n<\/div>\n\n
\n \nIncident\/Employee Information<\/strong><\/p>\n
- \n
- Employee\u2019s name<\/li>\n
- Employee\u2019s Job Title<\/li>\n
- Employee\u2019s Phone Number<\/li>\n
- ID# – your social security number<\/li>\n
- Date of birth<\/li>\n
- Did the injury happen at work?<\/li>\n
- When did it happen? Date and Time of Incident<\/li>\n
- Where are you injured? Injured Body Part & Injury Type<\/li>\n
- What happened?<\/li>\n<\/ul>\n\n<\/div>\n<\/div>\n
A copy of this report will be sent to the Worker’s Compensation carrier and to Human Resources for follow-up.<\/p>\n
Review the Workers’ compensation for the State of Arizona Employees Brochure “What you need to know”<\/a><\/p>\n
Supervisor Responsibilities<\/strong><\/h4>\n
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\u00a0 LOUIE – HR.<\/strong><\/a><\/p>\n
- City:\u00a0Flagstaff<\/strong><\/li>\n
- Location:\u00a0416- Northern Arizona University<\/strong><\/li>\n
- Use the Agency Code of 416 for <\/strong>Northern Arizona University.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n