Saint Paul College Policies & Procedures

04.12.00.1 - Workers’ Compensation Procedure

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.


Reference

Review Date

-

Policy Status

Approved

content_copy