Whenever any Plymouth State University employee is injured on the job, a Workers’ Compensation First Report of Injury (PDF) must be submitted, even if the employee does not seek medical attention. This form must be completed with the employee’s supervisor, and forwarded to the Human Resources Office immediately after the accident occurs. To ensure that the form reaches us quickly, please either hand deliver it to us or fax it to us at (603) 535-2655 and then place the hard copy in campus mail. HR must then complete and forward it to the Department of Labor in a timely fashion in order to avoid costly fines. Our Workers’ Compensation insurance carrier is MEMIC Indemnity Company.
