Workers Compensation Forms/Procedures

Norfolk Public Schools strives to ensure a safe working environment for all employees.  However, occasionally work related injuries do occur.  If you are injured while at work, please follow the directions below. All necessary forms are available on this page.

  • Report the injury to your supervisor immediately.
  • Complete and submit an accident report and Doctor Choice-Form 50 within one hour.
  • If medical attention is necessary, give your treating doctor the Medical Authorization Form.
  • Return the Medical Authorization Form to HR or your building principal after each doctor’s appointment.
  • Follow any doctor’s orders and restrictions at home and at work.

Please Note:

  • It is the responsibility of the employee to maintain consistent communication throughout their treatment process with Norfolk Public Schools when receiving workers’ compensation benefits.
  •  It is the responsibility of the employee to adhere to any work restrictions that may be given by their treating physician.
  •  It is the workers’ compensation company, not Norfolk Public Schools that determines payment of workers’ compensation claims.


Accident Reporting Procedures

Accident Reporting Forms

Accident Investigation Form (Building Principal Completes)

Rights and Obligations