Instructions for Supervisors
- Complete a Supervisor's Report of Incident, Injury, or Illness (see instructions below).
- If applicable, have any witnesses complete the Witness Statement. Send original Witness Statement to Worker's Compensation Specialist within two days.
- Immediately notify the Worker's Compensation Specialist if the employee will need (or has received) medical treatment.
- Fax or provide a copy of the supervisor's report to the Worker's Compensation Specialist within 24 hours.
- Do not allow the employee to return to work before clearing it with the Worker's Compensation Specialist.
Supervisor's Report of Injury Instructions
- Download the Supervisor's Report of Incident, Injury, or Illness
- Fill out form in Adobe
- Print form
- Sign the form (supervisor signature is required)
- Send form via TXST File Transfer to kb1569@txstate.edu and lt05@txstate.edu
Do not send forms to ehsrem@txstate.edu
For questions, please call 512-245-3616