Resource Browser
| Filename | Description | Updated | |
|---|---|---|---|
| 1E-Take to Doctor | Injured Employee: Take this form to your doctor. It includes instructions and authorization for workers compensation. | ||
| 1S-First Report of Injury | The injury report should be completed by the supervisor or designee within 24 hours of the employee's injury. | ||
| 1S-First Report of Injury (MAC) | The injury report should be completed by the supervisor or designee within 24 hours of the employee's injury. MAC version. | ||
| 2E-Doctor Choice Form | Doctor Choice Form 50 - Nebraska | ||
| 2S-MPS Incident Investigation Report | Supervisor Investigation Report MAC Version. The supervisor should complete within 48 hours of the injury. | ||
| 2S-MPS Incident Investigation Report | Supervisor Investigation Report. The supervisor should complete within 48 hours of the injury. | ||
| 3E-Employee Follow-up Form | |||
| 3E-Employee Follow-up Form | MAC Version | ||
| 3S-Supervisor Follow up | Supervisor Follow-up Form MAC Version | ||
| 3S-Supervisor Follow up Form | |||
| 4E - First Fill Prescription Form | Injured Employee: Get your workers' compensation prescriptions filled. | ||
| Employee Flow Chart for Injuries | Instructions if you are injured at work | ||
| Rights & Obligations | Workers Compensation Information Sheet | ||
| Rights & Obligations (Spanish) | Workers Compensation Information Sheet (Spanish) | ||
| S-Supervisor Flow Chart for Injuries | Instructions for supervisors if an employee is injured at work |