Free Sample Workers Compensation Policy
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Sample Workers Compensation Policy

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Workers' Compensation and Employee Accidents


Employees who are injured on the job or develop work-related health problems must immediately report them to the supervisor to assure proper processing of claims.  The supervisor must complete and submit a Report of Injury to Human Resources within  workdays of the injury or notification of a work-related health problem.

Statutory Benefits

Under state law, ABC provides the following benefits: medical attention, hospital care, rehabilitation costs, compensation for permanent disability, compensation for lost time, and compensation for death.

Compensation for lost time begins on the  calendar day of disability.  If the disability continues for more than 14 calendar days, compensation is paid for the first  calendar days of disability.  ABC assumes the entire cost of Workers' Compensation Insurance.

Supplemental Benefits

ABC will also provide supplemental benefits for regular employees as follows:

·         During the first  calendar days of disability, employees receive their regular salary.  This is not charged against accrued sick leave credits.

·         On the  day of disability, employees receive compensation benefits as provided by the State ABC Workers’ Compensation Act.  Employees with sick-leave credits can use them to “top-up” their compensation benefit until these credits have expired.  This enables employees to receive their regular pay during the disability.  If sick-leave credits are exhausted, the employee may use accrued annual leave in the same fashion.  Combined compensation benefits and supplemental benefits cannot exceed the employee's regular pay. In the event of an overpayment, ABC will make adjustments to the employee's next scheduled paycheck and leave credit balances.

·         Employees will be given a temporary medical disability leave of absence without pay if their eligibility for supplemental benefits has terminated or sick leave/annual leave has been exhausted.

·         Time away from work covered under the Workers' Compensation Act is not a break in continuous or creditable service with respect to eligibility for sick leave, annual leave, pay adjustments and retirement.

Maximum Benefits

Benefits will ensure employees do not receive more than their normal pay when combining the statutory benefit and the supplemental benefit.


Medical expenses and compensation are covered for employees who are injured on the job or develop work-related health problems.

Death benefits are provided should the accident or disease result in death.

Payable Expenses

State statute will determine whether medical expenses and compensation are payable, the amount(s) and the duration of such payments.


Injured Employee

·         Immediately report any work-related accident or illness to the supervisor.

·         Seek medical care or treatment.

·         Inform medical care provider that the injury/illness is work-related.


·         Immediately obtain required medical care for the employee.

·         Immediately report death or severe injury to Risk Management.

·         Immediately investigate the accident, determine cause(s) and identify prevention steps.

·         Within  workdays of the accident, complete the Report of Injury or Illness and forward it to Benefits.

·         Notify Benefits when the employee returns to work after a work-related injury or illness.  Complete the Return to Work form, attach medical certification, and forward it to Benefits.


Immediately report all work-related accidents and illnesses to the appropriate supervisor, regardless of the severity or cause.

Any work-related accident or illness resulting in death or severe injury must be reported immediately to Risk Management.

The supervisor immediately investigates the accident to determine the cause and develop preventative measures.

The employee should seek immediate medical care.  If the employee is seriously injured and cannot be moved, the supervisor should call for an ambulance.

The cost of medical care resulting from a work-related injury or illness is paid by State ABC's Workers' Compensation Program.

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