Workers' Compenstation Supervisor Handbook
Handbook created by the NC Office of State Human Resources to assist supervisors with
information regarding the Workers' Compensation process and associated policies and
procedures.
Workers' Compenstation Employee Handbook
Handbook created by the NC Office of State Human Resources to assist employees with
information regarding the Worker鈥檚 Compensation process and associated policies and
procedures.
Employee Incident Report Form
The employee incident report is the employee鈥檚 recollection of the details of the
injury. The report should be completed by the employee, and signed and dated as soon
as possible after the injury occurs.
Employee Use of Leave Options Form
Employees who miss time from work, should use this form to document their waiting
period leave selection as well as select rather or not they want to utilize supplemental
worker鈥檚 compensation payment after the seven day wait period.
Supervisor鈥檚 Incident Investigation Report
The supervisor鈥檚 incident report is the supervisor鈥檚 recollection of the details surrounding
the employee鈥檚 injury on the job. The supervisor鈥檚 report will list any details that
may correct the problem or to increase awareness in the department and the supervisor
and employee.
Workers' Compensation Refusal of Treatment Form
This form should be completed by injured workers who refuse treatment post injury.
NC Witness Statement Form
This form can be used by any witnesses to injuries that occur on campus.
Student and Visitor Incident or Accident Report Form
This form should be used for all injuries not classified as work related. Injuries
for students and visitors should be documented using this form.
Workers' Compensation Fraud or Abuse Allegations Report Form
Please complete this form if you have witnessed a case of fraud or abuse by a Workers'
Compensation claimant.
Form 17 Notice to Injured Workers and Employers
NC Industrial Commission Workers' Compensation Notice to Injured Workers and Employers