Subscribe:Posts Comments

You Are Here: Home » How To... » Injury Notification Policy: Part 4 – Sample Policies

This entry is part 2 of 7 in the series Injury Notification Policy

The following are samples of text that can be used to relay your injury notification procedure:

 All injuries must be reported to Jane in the Human Resources Department immediately. She will complete the necessary paperwork and notify our insurance carrier.


If you are injured, you must notify your supervisor immediately or before the end of your shift. Do not clock out if you have an injury. Your supervisor will assist you in completing the necessary paperwork, and he or she will forward it to the Human Resources Department immediately. You must complete the appropriate paperwork before you leave our facility.


 All injuries must be reported to your immediate supervisor, even if you do not need or want to receive medical treatment.
Your supervisor will complete an injury report and forward a copy to the Human Resources Department.
Our insurance carrier requires us to document all injuries.

  And you may also want to add the following text:

If you are seriously injured, we will call 911 and you will be taken to the nearest emergency room.
We will then complete and submit the necessary paperwork to our insurance carrier.
You will be contacted by the adjuster within twenty-four hours.


After reporting an injury, we will forward the necessary paperwork to our insurance carrier.
You will be contacted by the workers’ compensation adjuster within twenty-four hours of the injury.


Your supervisor will complete our “Internal Notice of Injury Form,” which includes an accident investigation section.
We conduct accident investigations so we can learn how the accident happened and to determine if we need to conduct
additional training or implement steps to prevent similar accidents in the future. We strive to make our workplace safe.

Series NavigationInjury Notification Policy – Part 3: Notification PolicyRTW Policies & Procedures: Injury Notification Policy – Part 1Injury Notification Policy: Part 5 – Supervisors Role
© 2010 Return to Work Resources · Subscribe:PostsComments · Designed by Theme Junkie · Powered by RTW Resources