Worker Comp


Worker's Compensation Forms

Employees and Student Workers must complete all of the following four forms when reporting an injury:


Student worker injury (FWS) must also complete this form: STUDENT WORKER FORM

Send all these forms by email to: Carmen Bradach

c.bradach@mesabirange.edu 218/749-7743


Supervisors: Please use the Supervisor Checklist every time you have an injury reported: Supervisor Check List