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:
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/her 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.
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.
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 employee’s death was work related, and, if approved, payment to survivors will begin.