Workers’ Compensation

The College administration, faculty, and support staff shall be provided an Employee Information Packet, including the following forms, which need to be completed by the injured employee: 1) Employee Statement Regarding Injury/Illness form, and 2) Leave Supplement form Whenever an injury occurs during the course of your work for Saint Paul College these forms must be completed and submitted to the Human Resources Office within three days of injury. 

Rev.4.00

If an injury occurs during the course of your work for Saint Paul College, you are responsible for reporting the injury immediately to your supervisor, lead administrator, or Human Resources Office and completing the “ Information and Privacy Statement” and the “Employee Statement Regarding Injury/Illness and the Leave Supplement Form”. The forms are available in the Human Resources Office, or printed from the following websites: www.risk-workerscomp.admin.state.mn.us/forms.htm and www.admin.state.mn.us/rick/wc. 

If the Employee Statement Regarding Injury/Illness form is turned into a supervisor or lead administrator, they must immediately notify Human Resources personnel via email or in person, and promptly submit the Employee Statement Regarding Injury/Illness form to the Human Resources Office to begin the process of determining eligibility for workers compensation benefits, if the illness/injury is compensable under Workers’ Compensation. All forms must be returned to Human Resources within 3 days of the injury. 

The Information and Privacy Statement should be given to injured employees prior to obtaining information from them on the Employee Statement Regarding Injury/Illness. This form is used to ensure compliance with the Minnesota Government Data Practices Act. 

Injured employees should be treated by Saint Paul College’s designated CMC network clinic (check with Human Resources for current designated clinic) or if they have an established relationship with a doctor (i.e. seen within the past year) can go to their primary care clinic. If it is an emergency, they should go directly to Regions Hospital Emergency Room.