If an employee is injured at work they may be eligible to receive Workers Compensation Benefits. The District’s Workers Compensation Policy (Policy 400.10 Workers Compensation) governs these benefits. In order to be eligible for Workers Compensation Benefits, the employee would need to have been injured while actively fulfilling the duties of their position. The injury must be reported and documented with the Form 122. A copy of the Form 122 must to be sent to the District Insurance Coordinator for any injury requiring medical attention. Injuries requiring medical attention must be evaluated and treated by the appropriate and approved medical provider. Medical providers don’t require the Form 122 – administrative staff should keep this form for their files. Authorization forms to receive medical attention are located below. Send employees with an authorization form not the Form 122. Depending on the severity of the injury it may take some time before they are cleared to return to work.
Please note: Falsifying or intentionally reporting inaccurate injury information in order to receive Workers Compensation Benefits may be considered fraud which is a crime and could result in legal action and or an adverse employment action up to and including termination.
Most injuries in the District are minor and require minimal, if any, medical attention. The Form 122 is only required for injuries that require a medical evaluation and treatment. In the event of a more serious injury, we prepared the following guidance to help you determine what to do. These are intended to be guidelines. In the case of an actual emergency use your best judgement. If there is a serious injury and you are unsure what to do, call 911.
Should I call 911?
If a work place accident has occurred and the employee has received serious injuries particularly to the the head, neck or back, if they have lost consciousness, can’t move, or if they have sustained any potentially life threatening injury call 911 immediately.
Should I go to the Emergency Room?
For serious injuries requiring substantial medical assistance, where the injured employee is stable and mobile proceed to the nearest Emergency Room.
Should I go to Occupational Medical Provider.
For most workplace injuries the District’s contracted Occupational Medical providers (Concentra or WorkMed) will be the best providers to evaluate and treat the injury. These providers are specialists in Occupational Health and will be instrumental in developing a treatment plan to help the injured employee recover quickly. This would include strains, contusions, falls, bites, minor cuts, etc.
What should I do with minor injuries that do not require medical attention?
Render first aid as applicable and document the injury. If the injury doesn’t improve or worsens send them to a contracted Occupational Medical provider to have the injury evaluated.
Concentra
Draper Location
12422 S. 450 E.
Draper, Utah 84020
(801) 748-1600
8:00 to 5:00 pm – Monday-Friday
Sandy Location
385 W. 9000 S.
Sandy Utah 84070
(801) 562 – 5200
8:00 am to 5:00 pm – Monday – Friday
WorkMed
South Jordan Location
1091 W. South Jordan Parkway Suite #500
South Jordan, UT 84095
385-887-7200
8:00 am – 5:00 pm – Mon – Fri
Murray Location
201 E. 5900 S. #100
Murray, UT 84107
801-288-4900
8:00 am – 5:00 pm – Mon – Fri
Salt Lake Location
1685 W. 2200 S.
Salt Lake City Utah 84119
801-972-8850
7:30 am – 7:00 pm – Mon – Fri
All injuries should be reported to your supervisor, ideally within 24 hours. It is the responsibility of the District to document and report any injuries that require medical attention. The administrative team at each location or department should document any injuries by using Form 122 First Report of Injury to document the injury. If the injury required medical treatment a copy of the Form 122 needs to be sent to Robert Reeder in the District Insurance Office.
Robert Reeder
9361 S. 300 E.
Sandy, Utah 84070
801-826-5448
Robert.Reeder@canyonsdistrict.org
If you encounter hazardous or dangerous working conditions that you believe could potentially injure an employee or student, you can report that issue to Ryan Jakeman the District Risk Manager. He will investigate the situation to see if the dangers can be appropriately mitigated to ensure employee/student safety.
Ryan Jakeman
Canyons School District
Risk Manager
Cell (801) 557-4514
riskmanagement@canyonsdistrict.org
