resources

Family Connections

Getting Involved

Tools

Resources

Leadership

About

Getting Involved

Workers Compensation

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.   

  1. TitleSizeHitsDate modifiedDownload
    Workers Comp Notice to Employees2022249.49 KB50808-08-2022 DownloadPreview
    Concentra Custom Authorization Form179.40 KB44608-08-2022 DownloadPreview
    WorkMed Authorization form390.45 KB40108-08-2022 DownloadPreview
    Basic Form 122267.25 KB50108-08-2022 DownloadPreview

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

Workers Compensation

en_USEnglish

Americans with Disabilities Act (ADA) Statement

Canyons School District is committed to making this website compliant with the ADA. At this time, we recognize that not all areas of this website may be ADA compliant. We are currently in the process of redesigning and creating new website content to be compliant with the W3C Level Two guidelines. If you are experiencing issues with this website, please contact us here communications@canyonsdistrict.org

Lucie Chamberlain

Alta View Elementary

If a movie about super teachers were ever made, Lucie Chamberlain would be a prime candidate for a leading role. Fortunately for her kindergarten students at Alta View Elementary, she already thrives in a supporting role for them. Parents thank her for being a “super teacher.” She is also described as an “amazing colleague.” Whether students need help in the classroom or from home while sick, Lucie goes above and beyond to help them learn, overcome fears, and feel important and cared for. Lucie is the reason a number of kids went from hating school to loving it, according to parents. The way she exudes patience, sweetness, positive energy, and love for her students with special needs melts is appreciated and admired. One parent noted: “Both my kids wish she could be their teacher forever.” Another added:  “She treats every student like their learning and their feelings are her priority.” Super teacher, indeed!

Specialty Schools

High Schools

Elementary Schools

Middle Schools