Worker's Compensation (CIRMA)

Workers Compensation

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:  Lucy Gennuso, Board of Education  (Personal Fax # 638-1457) or through interoffice mail.  Please keep a copy for your records.

The Witness Statement should be filled out only if there are any witnesses to the incident.

The Supervisor’s Accident Investigative Report should be filled out by the employee’s supervisor.  The purpose is to find out how a similar incident can be prevented in the future.

(It is important that this office receives the accident/injury form a.s.a.p. even without the other two forms initially, if there is delay in completion.)

If further medical attention is needed after seeing the school nurse, the employee should be immediately referred to Middlesex Occupational Medicine (in the Outpatient Center - 2nd floor), 534 Saybrook Road, Middletown, CT for care.

Middlesex Occupational Medicine’s telephone number is (860) 358-2750, option 6.  Should you need assistance in scheduling an appointment, you can either contact me at (860) 638-1409, or any of the school nurses and/or secretaries.

Should an employee need emergency care, please proceed directly to the ER. 

Statement of Board of Education Executive Management Commitment to Risk Management dated November 27, 2012

Revised Notice of Privacy (Click on this link)

*Please note:  If a contracted worker or any person who is not an employee is injured on Board property, he/she would not be covered under CIRMA Workman’s Comp. insurance, but rather should submit a letter to the Town Clerk’s office at City Hall advising the City of the incident along with any supportive documentation I would appreciate being notified of any injury that occurs.


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