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Instructions and Forms for OJI
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| Instructions for Department Supervisors This Adobe Acrobat PDF file contains basic information for Supervisors. If you have questions, please call 205.934.5548 or 205.868.0288. Initial Medical Evaluation Authorization The Supervisor should complete this form and send it with the employee to The Workplace for medical treatment. (If injury occurs after hours or in event of life-threatening injury, send the employee to the University Hospital Emergency Department) OJI Incident Report If you have access to Trend tracker (the electronic incident reporting system), do not use the paper incident report. If you do not have access to Trend tracker, the paper incident report form must be completed by employee and signed by supervisor to be forwarded directly to: Gail Pilkerton AB 360 If employee is unable to complete the form, the supervisor can complete it. How to Apply for OJI Benefits This form contains information for the employee about the OJI Program. The injured employee should read this form carefully. OJI Benefits Application An employee applying for OJI Benefits must fill this form out completely in order to be considered. Release of Information This form should be filled out by the employee. Any incomplete or altered forms will result in a delay of the claim process. OJI Time Sheets The Supervisor should complete this form on the eligible biweekly employee and forward in a timely manner to avoid delay in payment of lost time wages. |
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