Worker's Compensation Procedures

Supervisor's Report of Industrial Injury - The Employer's Report of Injury must be sent with this form

The Maricopa Community Colleges provides, at no cost to the employee, Industrial Compensation Insurance. A work related injury or illness is one in which the injury or illness arises out of the course of your employment during working hours. Any injury to an employee during working hours must be reported immediately to their supervisor. The employee and the supervisor must complete the Supervisor’s Report of Industrial Injury. If medical attention is sought, a copy of the Supervisor’s Report of Injury is to be forwarded to the Industrial Representative at the college or campus location. The industrial representative will complete the Employer’s Report of Industrial Injury. All completed forms are then forwarded to the Employee Benefits Department at the District Office. All injuries must be reported and forms completed within 24 hours from the time of injury.

When medical attention is needed, pursuant to ARS 23-908 Sec. E, the employee proceeds to the nearest Concentra Medical Center (CMC) or Healthworks Medical Walk In Centers (HW MWI) for initial treatment of the injury.  If there is a life threatening situation, call 911 for ambulance transport to the nearest hospital emergency room.

A Board Approved employee absent due to an industrial accident, resulting in injury or illness to the employee, will be allowed up to thirty (30) calendar days absence without loss of pay and without loss of current or accumulated sick leave. During this thirty (30) day period the District will pay the employee the difference between the wage loss benefit check received under the Industrial Compensation laws of the State and their regular earnings to equal their daily rate of pay. Beginning the thirty-first (31st) day, sick leave will be used to make up the difference between the total salary of the employee and the wage loss benefit checks received from Worker’s Compensation by the employee. The employee will also cease accruing sick hours. At the exhaustion of all sick hours, the District will cease to pay the difference between the benefits check and the employee’s full rate of pay.

Upon return to work, the employee must provide the Employee Benefits Department with a Doctor’s release to return to full duty. If the employee is released to light or modified duty, the medical release must indicate physical limitations and approval for return to work must be granted by the employees immediate supervisor. When an employee returns to work and needs additional follow up visits for therapy, flextime or sick leave must be used.

Last modified: June 25, 2007

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