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Any employee incurring an injury while engaged in his/her performance of District duties shall abide by the
following procedures:
A. Employees are responsible to immediately report all work-related accidents/illnesses to their supervisor.
(Any accident or injury that is not reported to your supervisor on the day of the injury or in a timely manner
must be personally reported to the Director of Human Resources by the employee.)
B. Employees are responsible for completing the Employee Accident/Injury/Exposure Report form. Also to be
completed is the Authorization of Release of Health Information. Return completed and signed reports to the
supervisor before the end of the shift on the day of the injury/ illness. (Reports will be provided by the
supervisor.)
C. Obtain an Attending Physician's Return to Work Recommendations Record from your supervisor, which is to
be completed by the physician before your evaluation is completed. This form is to be returned immediately
to the Human Resources Department.
D. To ensure timely medical care, the Wauwatosa School District has made arrangements with Concentra,
2455 N. 124th St., Brookfield, WI 53005 for initial evaluation of work-relatedinjury/illness or exposure. Their
phone number is 262-782-9326. Also Froedtert Hospital at 9200 W. Wisconsin Avenue, 414-805-3000.
However, you may seek medical attention from the provider of your choice.
E. The School District has been developed a modified duty return to work program which is designed to allow
placement of employees, in most instances on temporary, modified duty jobs providing that you are not
hospital-confined, bed-confined, or quarantined. It is your responsibility to accurately inform the treating
physician of the availability of this type of work for you.
F. If you are released to work with documented medical restriction, you are to work within these restrictions
only, no exception. (An employee's physical limitations/restrictions are effective twenty-four (24) hours per
day. Any employee not following their restrictions may cause a delay in the healing process and may further
aggravate a condition. By not following the restrictions, an employee may be subject to disciplinary action.)
Approved/Adopted: July 13, 2009 Revised/Approved: August 21, 2013 |
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