Policy Text
Instructional Order V.6:01
Revisions or additions are highlighted 1 (04/29/2024 ) ST. PETERSBURG POLICE DEPARTMENT
INSTRUCTIONAL ORDER
Subject: INJURY REPORTING/WORKER S’ COMPENSATION
Index as: Employee Injury Report No Duty
Exposure Control Officer On-duty Injury
Family Medical Leave Senior Operations Analyst
FMLA Police Training Specialist
Injury Report Reintegration
Illness/Injury Report Telephone Reporting Unit (TRU)
Light Duty TRU
Medical Leave Workers’ Compensation
Accreditation Standards: 46.1.7
Cross Reference: G.O. III -13, Leave Due to Illness
G.O. III -29, Family Medical Leave Act (FMLA)
I.O. V.5: 22, Infectious Diseases
City Rules and Regulations Section 6 -6, F.2.h
§§ 112.18 , 112.181 , 440.185, §440.185(4) , Florida Statutes
Replaces : I.O. V.6: 01, Injury Reporting/Workers’ Compensation (April 10, 2020 )
This Order consists of the following sections:
I. Purpose
II. Forms
III. Reporting of Injury or Illness Procedures
IV. Light or No Duty Status Procedures
V. Documentation Procedures
VI. Confidentiality
VII. Law Enforcement Special Provision
VIII. Procedure s for Return to Work
IX. General Information
I. PURPOSE
A. The purpose of Workers’ Compensation is to provide employees with healthcare services and/or compensation
when injured or in an accident arising out of , and in the course of , employment.
B. Timely reporting of work -related injuries is required to ensure comp liance with State -mandated requirements. The
State may fine employers for late reporting.
C. The completion and routing of a Report of an Injury to an Employee to Commer cial Risk Management (CRM) in a
timely manner is imperative.
D. The Senior Operations Analyst, Fiscal Services Division , is the designated Exposure Control Officer for the Police
Department.
DATE OF
ISSUE EFFECTIVE DATE NUMBER
August 2017 Immediately V.6:01
Distribution: All Employees
Instructional Order V.6:01
Revisions or additions are highlighted 2 (04/29/2024 ) II. FORMS
All forms and additiona l information related to the injury/illness reporting process can be obtained on the City’s Intranet
and the Department’s Computer Aided Read Off System (CARS) . Forms include:
A. Report of an Injury to an Employee Form (Link)
B. Workers’ Compensation Brochure
C. Workers’ Compensation Q&A
D. Workers Comp FMLA Designation Notice
E. Workers’ Compensation Report Injury Instructions ( Reporting On -The-Job Injuries/Accidents Instructions )
F. Workers’ Compensation On Duty Injury Supplemental Pay ( Authorization for ) Extension Form
G. Workers Comp FMLA Memo
H. Workers Comp Notice of Eligibility and Rights and Responsibilities
I. Light Duty Assignment Form
J. Light Duty Time Sheet
K. Light Duty Work Program
III. REPORTING OF INJURY OR ILLNESS PROCEDURES
A. All on -the-job injuries or illnesses must be re ported immediately by each employee to their respective supervisor
regardless of whether medical treatment is needed or not.
B. A Report of an Injury to an Employee form must be completed within 24 hours .
C. If any injury/accident is questionable, contact the Commercial Risk Management (CRM) . The Senior Operations
Analyst, Fiscal Services Division may also be contacted during normal business hours . Commercial Risk
Management reserves the right to investigate any claim to determine compensability.
D. Upon determining a work -related injury or illness has occurred, the following actions must immediately be taken:
1. The employee will report the injury/illne ss to the supervisor in charge and they should determine if medical
treatment is necessary. If there is any doubt, the decision should be made to seek treatment to protect the
employee.
2. If medical treatment is necessary, the injured employee is to report to the nearest open clinic. A list of the clinics
can be found in the Workers’ Compensation Report Injury Instructions . The physicians at these locations are
designated to coordinate t he necessary medical treatment.
3. Upon arrival at the clinic, it is necessary for the employee to present their City employee identification and the
Workers’ Compensation Information card for insurance purposes . The employee should follow up at the same
clinic where initially seen.
4. In the case of serious emergencies, or if treatment is outside of the clinic operating hours , the employee should
be taken to the nearest hospital emergency room as identified in Workers’ Compensation Report Injury
Instructions . Physicians at these locations are designated to coordinate the necessary medical treatment.
Instructional Order V.6:01
Revisions or additions are highlighted 3 (04/29/2024 ) 5. If the employee is transported via ambulance due to severe trauma , the employee should be taken to the
nearest emergency room that can best provide care, as may be determined by the treating paramedics. This is
the only exception for an injured employee to be treated at another facility other than those identified.
6. The employee’s immediate supervisor will review the Medical Disposition/Treatment Plan received from the
treating physician or facility and determine if the employee full, light, or no duty .
IV. LIGHT OR NO D