Injured at Work
You've been injured on the job. What do you do now?
If you are injured on the job, and your injury requires more than simple first aid, you will need to go to one of our treating facilities for medical care. A list of approved providers is listed below. You can get a list of approved providers in the office at each work location. If the injury is life threatening please go directly to the nearest hospital for treatment or call 911.
As soon as possible, report the injury and the detail of your injury to your supervisor/or school secretary. This information will be used for your claim to be called into Pinnacle (Jordan School Districts 3rd party Workers Compensation provider).
The health care provider will give you a work status form at the end of your treatment. If they do not automatically provide you with a work status form, you will need to ask them for a copy of it. If the Work Status form indicates that you can fully return to your job without restrictions, you can return to work. Please give the Work Status form to the Secretary for your facility to fax to Human Resources. If the Work Status form indicates that you can work with restrictions, you must contact Human Resources immediately. Based on the restrictions provided on the Work Status form, the Human Resources Benefit Manager will determine if you can return to work, or if you will be off work.
If you have been taken off work by the Human Resources Benefits Manager and you will be out of work for more than three (3) days, you must apply for FMLA (Family Medical Leave Act). FMLA is a federal law that protects you, the employee while you are out on Workers Compensation. FMLA runs concurrent with Workers Compensation. FMLA protects your job and provides that your Health Insurance Benefits remain in force while you are out of work (Provided you continue to pay your portion of the health insurance.) In order to qualify, you will need to have worked for the District for at least one year and have worked 1250 hours in the previous 12 months.
You will need the following forms to apply for FMLA for your injury:
- Request for Family Medical Leave Act (FMLA)
- Work Status (provided by your WC physician)
The completed Request for Family Medical Leave form can be submitted online, faxed to 801-567-8056, hand delivered, or sent interoffice mail to the Human Resource Department- Benefits.
Until such time when you are able to return to work, you will need to provide the Work Status form to the Human Resources Benefits Manager each time you are treated. The Work Status form will be reviewed to evaluate whether you can return to work.
Workers Compensation is a partially paid leave. You can however use your accrued leave to make up the difference between wages paid by WC and your full daily rate. You can contact Human Resources at 801-567-8249 or Payroll at 567-8154 to determine the amount of leave days you have available to use.
If you do not have enough leave days to cover your leave, you may qualify for the Employee-Funded Sick Leave Bank. Please review the correct policy for the Licensed or Classified. If you determine that Employee-Funded Sick Leave Bank is a good option for you, you make a request for these benefits by completing the Request for Employee-Funded Sick Leave Bank Form Licensed/Classified.
Please feel free to give Human Resources a call at 801-567-8249 should you have any questions or concerns regarding your leave.

