Work Injury Reporting
Please complete the Employee and Supervisor Investigation Form immediately
and send to Human Resources.
Delay in reporting accidents, injury, or work-related illness could result in a delay, or denial, of benefits.
Employee's Notice of Accidental Injury or illness Form/Incident Investigation Form
Employee Responsibilities
If you are to sustain an injury or become ill as a result of workplace conditions or work activity YOU MUST:
Verbally report the incident to Human Resources immediately. If, because of the nature of the injury or illness, an employee is unable to report, it is the responsibility of an other worker, who happens upon the incapacitated worker, to promptly report the event to Human Resources.
Notify your immediate supervisor
Complete the "Employee First Report of Injury Form" (below) and send to Human Resources within 24 hours, unless the nature of the injury requires additional time.
Manager/Supervisor/First Aid Provider Responsibilities (for incidents on school premises)
Upon notification of an injury or illness:
Promptly ensure that first aid is administered by a qualified first aid provider.
Ensure the employee is given subsequent medical treatment, if necessary, and provide emergency transportation to treatment, if necessary.
Notify additional rescue/response teams (SERT, Hazmat, etc.), if necessary.
Immediately notify Human Resources.
Complete the "Supervisors Reporting Form" (below) and send to Human Resources within 24 hours (207-475-1338).
Human Resources Responsibilities (upon notification)
Review/Complete Employee and Supervisors Reporting Forms
Report findings to Maine State Worker's Compensation through Maine Municipal Association online reporting within 24 hours of receiving paperwork (or within three days of date of injury, whichever is sooner)
Ensure appropriate personnel within the district are notified.