All work-related injuries must be reported to the employee’s supervisor or by contacting Human Resources at 218-683-8634 within 24 hours of the date/time of the injury, at which time the supervisor, along with the injured employee, will need to complete the Incident/Injury/Illness Data Form (IDF) as well as the Employee Statement. If the injury is life-threatening or fatal, Human Resources must be notified immediately.
The employer & employee should retain a copy of the IDF. Supervisors of the injured employee, along with the employee, must also review and complete the supervisor’s checklist to ensure all appropriate forms are completed, and the injured employee receives proper paperwork. Additional information and forms can also be found on the State Workers Compensation Web site.
If an employee receives treatment and has any work restrictions, this needs to be in writing from the treating physician and given to the employee’s immediate supervisor with a copy to the Human Resources Office.
If medical attention is required, you must contact a medical facility nearest you.
CorVel Corporation is our workers compensation managed care plan. For 24-hour nurse line service, medical emergencies or if urgent care need is needed, you may call 1-866-399-8541 or 612-436-2542. These same procedures apply to student worker/work study students who are injured on the job. Please remember that Northland Community & Technical College employees need to work together in order to provide a safe and healthy work environment.
For additional information, go to the State Workers Compensation Web site.
Workers’ Compensation Procedures
NOTE: All injuries must be recorded in the system within 24 hours from the time of the incident.
Employee Forms
- Employee Information Packet
- Information and Privacy Statement
- Employee Statement Regarding Injury/Illness (MUST be filled out for all injuries)
- Leave Supplement Form
Supervisor Forms
- Agency Claims Investigation Form
- First Report of Injury – Injury, Illness, Incident Data Form (IDF) (MUST be filled out for all injuries. Employee and Supervisor may fill out together)
- Supervisor Injury, Illness and Incident Reporting and Workers’ Compensation Checklist