Workers' Compensation Program Filing Procedures
- Report all job-related injuries or illness to your supervisor immediately.
- Obtain a treatment authorization prior to seeking appropriate medical attention from the following authorized primary care physicians:
- FastMed Urgent Care
- 3215 Battleground Ave., Greensboro, NC 27408, 336-387-5020
- 5402 W. Market St., A, Greensboro, NC 27409. 336-387-3346
- FastMed Urgent Care
- Atrium Health Urgent Care
- 2005 Pisgah Church Rd. Suite A, Greensboro, NC 27455, 336-716-9150
Note: In case of a life-threatening emergency, go to the nearest medical facility.
- 2005 Pisgah Church Rd. Suite A, Greensboro, NC 27455, 336-716-9150
- Contact 911 for emergency transportation to Moses Cone Hospital-Emergency Room. If the injury or illness incurred would require assistance with non-emergency transport, the injured worker’s immediate supervisor should transport the employee to and from the initial medical visit. If the immediate supervisor is not available, then the next in line supervisor or manager should transport the employee, ensuring a safe return.
- Return to work after your medical treatment unless your authorized physician provides you with a written authorization prohibiting your return to work.
- All medical notes given to you at medical treatment should be given to supervisor and/or the Workers' Compensation Administrator. If you have any medical restrictions as a result of the work-related injury, you must provide written documentation from the authorized physician.
- Follow all medical restrictions; your recovery is a major concern to the University.
- Provide the completed Employee's Accident Report Form with details of the accident to your supervisor.
- NOTE: Be sure to contact the Division of Human Resources-Benefits Unit with questions regarding payment and/or continuation of employee benefits. Refer to the "Continuation of Benefits" section in the State of North Carolina Workers' Compensation Employee Handbook for additional information.
- Keep supervisor notified of any changes in medical condition or any concerns in reference in your case.
- Follow safe work practices!
Return all documents to Workers' Compensation Administrator, Ana Bracetty, 336-285-3788 or adbracetty@ncat.edu.
- Ensure that the job-related injured employee receives immediate and appropriate medical attention.
- Report the injury immediately to the Workers' Compensation Administrator, Marcie Rowdy, 336-285-3788 or adbracetty@ncat.edu in order to obtain a treatment authorization on behalf of the Employee prior to seeking initial care from an authorized primary care facility.
- If able to do so safely, employees should transport themselves for treatment. If they are not able to do so, dial 911 for emergency transportation to Moses Cone Medical Center Emergency Room. If the injury or illness incurred would require assistance with non-emergency transport, the injured worker’s immediate supervisor should transport the employee to and from the initial medical visit. If the immediate supervisor is not available, then the next in line supervisor or manager should transport the employee, ensuring a safe return.
- Investigate all injuries as soon as possible after the incident occurs.
- Correct unsafe conditions immediately.
- Maintain weekly contact with injured employee to ensure their needs are met. Keep employee notified of any departmental changes while employee is out of work.
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NOTE: Refer employees to the Division of Human Resources-Benefits Unit if they have questions regarding payment and/or continuation of employee benefits. Refer to the "Continuation of Benefits" section in the State of North Carolina Workers' Compensation Employee Handbook for additional information.
- Identify and notify the Workers' Compensation Administrator of modified, transitional duty available in your department. Assign transitional duty work as soon as the employee is medically able to return to work.
- Notify the Workers' Compensation Administrator if employee indicates a change in medical status or condition, or employee indicates absence is related to the injury.
- Encourage safe work practices!
- NC Supervisor Incident Investigation Report Form
- State of North Carolina Initial Claim Report Form
- Accident Reporting Packet
- Witness Statement
- Vehicle Incident Report - Use this form along with the others, if you are injured in a State vehicle
Forward all forms to the Office of Human Resources - Workers' Compensation within 24 hours of the incident or as soon as possible