Who
to Notify When an Accident Occurs
Employees experiencing an
on-the-job accident or injury or job-related property
damage should immediately or as soon as reasonably
practicable report the incident to their supervisor
stating exactly what happened, how it happened, who
witnessed the incident, and whether injury occurred as a
result of the accident. If you are a witness to a work
related accident where a fellow employee is injured
severely enough that the involved employee cannot notify
his/her supervisor, you should attempt to notify the
supervisor for him.
Examples of incidents which may
occur include, but are not limited to the following:
-
Accidents involving state-owned vehicles;
-
Accidents and mishaps involving state-owned machinery or
equipment;
-
Accidents caused by state employees acting within the
scope of their employment;
-
Accidents on state-owned or state controlled property;
and
-
Injuries to state employees incurred within the scope of
employment (workers compensation).
Injuries Not Covered
Compensation shall not be allowed for an injury or
death due to any of the following reasons:
- Willful misconduct;
- Intentional self-inflicted injury,
- Intoxication, and
- Willful failure or refusal to use safety devices
or perform a duty required by law.
Documentation of Accidents
The supervisor or employee
should immediately contact the Human Resources Office
once an accident has been reported. Close coordination
will be required to ensure required forms are completed
on a timely and accurate basis. As soon as possible
after an accident occurs, the supervisor must complete a
Supplementary Record of Occupational Injuries and
Illnesses Form. If the employee needs medical treatment,
he/she must complete an Accident Report Form. The
employee should fill out the Accident Report as
completely as possible, sign the form at the bottom, and
give the form to their supervisor to complete and sign.
All completed forms and any medical bills should be
submitted to the Human Resources office for processing
to Sedgwick James of Tenn. within 3 days of the injury.
In the event that the employee is unable to work due to
the work related injury, Human Resources should be
contacted.
The
employee is responsible for providing information from
the treating physician to his/her supervisor regarding
his/hers ability to return to work. Should the
employee elect to receive sick and annual pay rather
than temporary total disability benefits, the employee
should sign a statement that this is a voluntary
election on their part and realize that they will not be
eligible to receive temporary total disability benefits
during this period. Sedgwick James will provide benefits
to the employee until he/she is released from the
doctor's care.
Other Forms
The Employee Property Damage
Report Form should be completed for the loss, damage or
destruction of the personal property of state employees.
The
Claim for Damages Against the State of Tennessee Form
should be completed for personal injury or property
damage of persons not employed by the university and
mailed to the Board of Claims Office.
Copies
of these forms can be obtained from the Human Resources
office.
Limitation of Time
Claims must be filed no
later than one year from the date of occurrence. Failure
to do so will result in disallowance of the claim unless
evidence of extenuating circumstances is presented.
Attorney Fees
The party employing the
attorney must pay the attorney's fees. The law allows an
attorney to charge up to 20 percent of the payments
received. Sedgwick James should be notified in writing
of the name and address of the employee's attorney.
Death Benefit Claims
Should an employee's
compensable injury result in death, survivors are
eligible for certain death benefits under the workers'
compensation program. To receive these benefits, the
surviving spouse (or other surviving dependent) should
file a completed Accident Report Form with Human
Resources. Human Resources will then forward this form
to Sedgwick James. Once this form has been filed and any
requested documentation has been provided, Sedgwick
James will be able to determine if the employees
death was work related, and, if approved, payment to
survivors will begin.
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