Notification of Personal Injuries: Employee
Injuries which result in hospitalization, lost work-time, or which require medical treatment beyond first aid, will be investigated by the Department of Environment, Health and Safety for the purpose of analyzing the circumstances surrounding the injury, the possible need for corrective action, and whether it is compensable under the North Carolina Workers’ Compensation Act.
The employee is responsible for notifying his or her supervisor immediately of any job-related injury or illness. If the employee is not able to do so, a fellow employee should notify the supervisor as soon as practicable.
The supervisor is responsible for ensuring that the employee receives prompt treatment of the injury by obtaining first aid or medical treatment. If the treatment requires more than first aid, the supervisor or another person must accompany the injured to the appropriate medical facility for treatment. Supervisors are not to send injured employees unescorted to seek medical attention. The supervisor is also to notify the Safety Office / Environment, Health and Safety Office by telephone for follow-up.
The employee completes the form, Employee’s Incident Report Form, and submits it to his/her supervisor or Human Resource Facilitator for transmittal to the Department of Environment, Health and Safety.
The supervisor completes the Industrial Commission Form 19 and Employer’s Report of Injury to Employee, and forwards them to the Department of Environment, Health and Safety within 24 work hours of knowledge of the incident.
Note: Industrial Commission regulations require that the notification form be filed with the Industrial Commission within five days after the occurrence and knowledge of an injury; however, OSHA regulations require that injuries requiring medical treatment be recorded by the Department of Environment, Health and Safety within 48 hours. Therefore, it is imperative that injuries be reported to the Department of Environment, Health and Safety as soon as possible.
The supervisor must also complete the Supervisor’s Incident Investigation Form, to be submitted to the Department of Environment, Health and Safety along with Form 19.