As an employee of Littleton Public Schools, you have certain responsibilities under the Colorado Workers’ Compensation Act in the event you sustain a work related injury or illness. You may access the entire Workers' Compensation Program Packet.
Employer’s First Report of Injury form
- Report all work-related injuries or illness to your supervisor immediately and provide him/her with all necessary information to complete the Employers’ First Report of Injury. You are not to complete this form, the employer must complete it. Your supervisor may refer you to the school secretary for completion of the paperwork.
Employee Statement of Injury form
- Under the Colorado Workers’ Compensation Act, if you are injured on the job, written notice must be given to your employer within four (4) working days after the accident, pursuant to section 8-43-102 (1)(a). If the injury results from your use of alcohol or controlled substances, your workers’ compensation disability benefits may be reduced by one- half in accordance with section 8-42-112.5. Failure to provide this notice can result in reduction of benefits (up to one day for each day not reported) payable under the Workers’ Compensation Act.
- Bring your completed Employee Statement of Injury form to Becky Lujan, Benefits Technician, Human Resources, ESC, within four (4) working days of the work-related injury or illness. If requested, your Employee Statement of Injury will be date and time stamped and a copy will be provided to you for your records.
Designated Provider Medical Treatment Authorization form
- Complete the Designated Provider Medical Treatment Authorization Form and ask your supervisor, school secretary or a Human Resources representative to sign the form. If medical treatment is required, take the Medical Treatment Authorization form with you and give it to the designated provider’s office staff when you check-in for your first appointment.
- Obtain a copy of the medical report prior to leaving the designated physician’s office after each visit. The medical report contains the physician’s diagnosis, a release for return to work, any work restrictions, time off requirements, and any treatment or follow-up care required. It is important that you bring a copy of each medical report to your supervisor so he/she may determine appropriate accommodations for any work restrictions or is aware of time off requirements placed by the designated physician.
Report Absences in LARS
- Report any absences to the Littleton Absence Reporting System (LARS) as required by Board Policy using the Reason Code 8 (workers’ compensation). All absences using LARS code 8 (workers’ compensation) must be authorized by a designated physician.
Designated Provider Appointments
- In order for workers’ compensation benefits to be paid, it is important to keep all medical provider appointments. If you are unable to keep an appointment, please contact the medical provider to reschedule. You may be billed for medical appointments for which you don’t show.
- All medical appointments should be scheduled outside of work hours. All employees are required to take a copy of all medical reports to their supervisor followingtreatment.
- If you have been authorized to miss work, when the designated physician releases you to return to work, immediately bring the medical report indicating the release to the Human Resources Department so your District payroll may be reinitiated. You willalso be given a copy of the release to give to your supervisor and you must return towork at that time or, if your workday has ended, the next scheduled workday. Lost time benefits issued by workers’ compensation will stop as of the date of release.