Work Comp Reporting Procedures

If a paid Stetson employee is injured while in the performance of their required work duties, and the injury requires medical attention, (or is likely to need medical attention in the near future), the employee should notify their Supervisor immediately. Risk Management should then be notified ASAP so the work comp claim can be processed and authorized medical treatment can be arranged with a work comp approved provider if/when needed.

Accident Report Forms

If the above work-related injury occurs, please complete and sign the appropriate Employee Accident Report Form. (The Supervisor should review the form and sign off as well)

There are Two Accident Report Forms

» Employee Accident Report Form (General Employees)

» Student Employee or Paid Work Study Accident Report Form

Please print out the appropriate form, then complete and sign (info does not need to be typed). Signatures must be hand-signed and dated.

Per the Florida State Work Comp Statute, work-related injuries should be reported to the Employer as soon as possible by the Employee. If reported later than 30 days, the claim can be denied.

Once the Employee Accident Form is completed

Send the completed form to Risk Management so the injury can be reported to our Work Comp Insurance Company.

Risk Management Contact Info

Terry Gordon
Phone: 386-822-7701
Fax: 386-822-8873
Interoffice: Risk Mgmt- Unit 8420
Location: Facilities Management Bldg on corner of East Minnesota & Garfield Ave.

NOTE: Scan/Email is best since the form can be received by Risk Mgmt while in or out of the office.

Work Comp Authorized Medical Treatment

Serious Injuries/Emergency Treatment

If an injury is serious and requires immediate emergency treatment, call 911 and/or Public Safety at 386-822-7300. Notify Risk Management ASAP. (Email: / Phone: 386-822-7701)

General Medical Treatment

If Employee needs medical treatment that is not an emergency, Risk Management will obtain authorization from the Work Comp Insurance Company for employee to go to a work comp approved primary care provider. There are several in the near vicinity that the employee may choose from, and the list will be provided by Risk Management. Most of them have extended hours in the evening and on weekends.

After Hours

If a work-related injury occurs during an employee’s work-shift that is after normal business hours or when campus offices are closed, they should notify their Supervisor immediately (or Public Safety if Supervisor cannot be reached). The Employee Accident Form (above) should be completed and submitted to Risk Management as soon as possible so the claim can be reported to Work Comp on the next business day. Medical treatment will then be arranged with a work comp doctor if needed.

(If campus is closed for the holidays, please ask Public Safety to contact Risk Mgmt.)

Public Safety can assist with First Aide if needed. If the employee needs medical treatment beyond first aide that cannot wait for Risk Management’s return the next business day; the employee may go to a nearby Emergency Room for treatment (typically that is Florida Hospital DeLand). They should notify their Supervisor (or Public Safety) that they are going to the ER and advise which one. If the injury is serious and requires emergency medical treatment or ambulance, Public Safety should be notified ASAP (386-822-7300).

If ER asks about insurance, Employee should advise the ER that the injury is work-related and give them the Stetson Risk Management Contact Info so they can obtain our work comp billing info. (do not pay a health insurance copay).

Please notify Risk Management of any ER medical treatment ASAP (Email: or Phone: 386-822-7701 and leave message if not in)

NOTE: Risk Management will need the ER discharge paperwork to send in with the work comp claim. Any follow up medical treatment required will need to be arranged with a Work Comp medical provider and authorized by the Work Comp Insurance Company.

If any questions regarding Workers Comp, please contact Risk Management:

Email: / Phone: 386-822-7701