WHAT FORMS DO I NEED TO COMPLETE?

If you have an occupational injury you must complete the Accident/Incident Report form. 

If you are seeking medical treatment during your working hours and you are a budgeted employee eligible for College benefits you must also complete the Request In-line-of-duty Leave of Absence each time you go to a medical provider.

WHAT DO I DO WITH THE FORMS AFTER THEY ARE COMPLETE?

Accident/Incident Report

• Make sure to include the date, time, and exact location of the accident/incident.  This would include the Campus that you are working on.  If there are witnesses, get their information.

• After the form is completed fax it to 341-3040 immediately.

• You may keep the original for your supervisor to sign

• Forward the original to Risk Management after your supervisor signs it.

Request In-line-of-duty Leave of Absence

• This is for budgeted employees only.  OPS, adjunct instructors, student assistants, other employees, and/or eligible volunteers do not receive benefits and therefore are not eligible for paid leave of absence.

• The treating physician must remove the employee from work for this leave to be used.

• FAX the form to Risk Management 341-3040 and attach the original form, with your supervisor's signature, to the pay certifications and send to payroll.

  • Note:  Only you and your supervisor need to sign this form.  You do not currently need to have this go through the Cabinet Member, the President, and the HR Director. 

Additional Facts Regarding In-Line-Of-Duty Leave:

• Under Florida law, you are not paid for the first seven days of disability. However, if you lose time because your disability extends to over 21 days, you may be paid for the first seven days by the insurance company. Reference: Section 440.12 , Florida Statutes.

• St. Petersburg College allows for budgeted employees who receive benefits to be paid a maximum of 7 days of in-line-of-duty pay.  Since the College policy allows you to be paid for the first seven days you can not be paid this again by the insurance carrier.  This would be considered double-payment and you would be required to reimburse any overpayment.

• If you leave work for any reason you must notify your supervisor.

• The Request In-line-of-duty Leave of Absence must be completed each time you go to a medical treatment provider during your work hours.

• Medical treatment includes going to a specialist such as physical therapy, etc.