• Death
• Loss of consciousness
• Injuries that cause missed days of work or restricted work activity
• Any needle injury or cut from a sharp object that is contaminated with another person’s blood or any other potentially infectious material
• Injuries that require an employee to be medically removed under the requirements of an OSHA health standard
• Injuries that require any medical treatment beyond first aid (refer to the “Medical Treatment” vs. “First Aid” form)

AdvanStaff HR requires adherence to the following worksite accident / illness reporting policy.

The following steps are required in the event of a worksite or work-related injury or illness:

1. Employee(s) must report any and all accidents / illness to their supervisors immediately.
2. If the injury requires professional medical attention, a supervisor or a company representative should, whenever possible, accompany the injured worker to the medical care facility to ensure employee safety and that the appropriate forms are completed by the health care provider. Please be aware that the employee may also be subject to drug and alcohol screening. For a list of Concentra Medical Facilities click the following: MAP VIEW
   Authorized Care Locations for NV (88.64 kB)
3. AdvanStaff HR requires verbal notification within 24 hours of the accident. If your call is placed after work hours or during a weekend or holiday, please leave a detailed voicemail message at (702) 598-0000.
   
4. A C-1 Workers’ Compensation Incident Report Form must be completed and submitted as soon as possible immediately following the accident. AdvanStaff must receive this completed form within 48 hours of occurrence. Any questions left unanswered will delay the claims process.

   Fax the completed form to: (702) 598-0646
   C1 – Injury / Illness Report (119.38 kB)
   -or-
   C-1 Form – Notice of Injury or Occupational Disease (49.53 kB)

5. An AdvanStaff HR representative will contact you within 48 hours to discuss the accident. AdvanStaff HR will contact your workers’ compensation insurance carrier to file a claim if necessary. Please be aware that AdvanStaff HR and/or the insurance carrier may also contact the supervisor, the injured employee(s), or any witnesses to discuss the accident / illness in detail.

Following leave due to worksite injury, an employee must submit a return-to-duty authorization to AdvanStaff prior to returning to work. This authorization must come from the injured employee’s attending physician.

Please contact  the Human Resource Department with ANY questions.