Workers’ Compensation Instructions

WHEN AN INJURY OCCURS, NOTIFY THE SUPERVISOR IMMEDIATELY then complete the following steps:

  1. Call the Central Office 828.456.2400 directly and advise receptionist it is a Worker’s Comp call.  You will be directed to Phyllis Burchfield.  If Phyllis is out of the office you will be directed to Cindy Simson. DO NOT CALL DIRECT EXTENSIONS NOR LEAVE A VOICEMAIL.
  2. School/Location Worker’s Comp designee: fill out the following and fax immediately to Central Office 828.456.2438 or phyllis@haywood.k12.nc.us:
    • Form 19 with ALL highlighted fields filled in and form signed by principal or location supervisor (if other than a school).  
    • ACCIDENT.INCIDENT INVESTIGATION REPORT completed by principal or location supervisor (if other than a school).
    • Signed and dated Witness Statement
    • *If principal or location supervisor is not available, submit UNSIGNED forms via fax and send SIGNED forms via Pony Mail.
  3.  The employee should take the following forms and information to URGENT CARE in CANTON @ 55 Buckeye Cove Road(I-40, exit 31 next to Sagebrush):
  4. For further information please review -EMPLOYER PROCEDURES FOR ASSISTING INJURED EMPLOYEES

If you have concerns, questions or doubts about the employee’s injury, please contact Phyllis Burchfield or Cindy Simson at 828.456.2400.

Workers’ Compensation Helpful Links

NCDPI Workers’ Compensation
NC Industrial Commission
NC Workers’ FAQs

 

HCS Safety Plan
HCS Safety Plan