Workers' Compensation Plan
Incidents should be reported no more than 24-48 hours after an occurrence.
The Employee Accident/Injury Report form also known as the First Report of Injury is the document that initiates workers’ compensation benefits to the injured employee. Any delay involving the submission of this form, is delaying an injured employee’s receipt of benefits to which he or she may be entitled. The Employee Accident/Injury Report must be completed in its entirety, signed by a supervisor, and sent to my attention: Missy McCoy, Board of Education (Personnel Fax # 203-630-4205) or through interoffice mail. Please keep a copy for your records.
If further medical attention is needed after seeing the school nurse, the employee should be immediately referred to Yale New Haven Health in Hamden, CT for care.
Yale New Haven Health
2080 Whitney Ave., Suite 150
Hamden, CT 06518
P: 203.789-6240 F: 203.789-6243
Should you need assistance in scheduling an appointment, you can contact Missy Mccoy at (203) 630-4209. Should an employee need emergency care, please proceed directly to the ER.
- CT Workers’ Compensation Commission Website For specific information about your legal rights under the CT Workers’ Compensation Act.
- CT Department of Labor Worker Safety (Occupational Safety and Health - Conn-OSHA) Website
- United States Department of Labor Occupational Safety and Health Administration Website
- State of CT Payor and Medical Provider Guidelines
- First Report of Injury Reporting Information Form
- State of CT Form 30C: Notice of Claim for Compensation
- State of CT Form 1A: Filing Status and Exemption
- City of Meriden Incident Report Form