The following packet of information is provided for Supervisors to review and complete when there has been an injury/illness on the job.
Please note the Employer's Accident Report (EAR) must sent to Human Resources (704 Clement Street/P.O. Box 6889) within 24 hours of the report of injury/illness. All other forms need to be returned to the Department of Human Resources at Box 6889. Should you have any questions, please do not hesitate to call our office (540-831-5008).
Workers' Compensation Forms and Instructions
(for pdf forms, see instructions below for
obtaining the ADOBE Acrobat Reader)
1. Supervisor's Checklist for Workers' Compensation
word 2. Workers' Compensation Information for Supervisors
3. Employer's Accident Report (EAR) word 4. Instructions for Completing the EAR 5. Panel Physician Selection Form for Workers' Compensation
6. Workers' Compensation Fact Sheet for Full-Time Employees
7. Workers' Compensation Fact Sheet for Wage/Part-Time Employees
8. Supervisor's Incident Report for Workers' Compensation
9. Workers' Compensation Time Missed/Return-to-Work Notification
word 10. Workers' Compensation Request for Mileage Reimbursement
word 11. Workers' Compensation Request for Prescription Drug Reimbursement
word 12. Workers' Compensation Employee Instructions for Filing a Claim
You will need ADOBE Acrobat Reader 3.0 to view and print the PDF files. The reader may be obtained from the ADOBE website free of charge.
Radford University does not discriminate with regard to race, color, sex, sexual orientation, disability, age, veteran status, national origin, religion, or political affiliation in the administration of its educational programs, activities, admission or employment practices. Inquiries may be directed to the Director of Human Resources at P.O. Box 6889, 704 Clement Street. Telephone: voice (540) 831-5421; hearing impaired (540) 831-5128.
Last Modified -- Thursday April 16, 2009 01:17:56 PM