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Workers' Compensation Form 101

Body

Workers' Comp. Form 101 is submitted to Human Resources by an employing department if an employee is out for 5+ cal. days due to a work-related illness/injury.

Document Type

Forms

Topic

BenefitsUnpaid leavesWorkplace injury or illness

Audience

Benefited employeesFaculty MSP Calendar YearFaculty MSP Temp Non-BenefitFaculty Non-Unit Calendar YearGraduate student employeesHR partnersInternational employeesLibrariansManagersNEPBA New England Police Benevolent AssociationPolice IBPOPostdoctorate employeesRAPMUStaff AFSCMEStaff Non-Unit ProfessionalStaff PSU Unit AStaff PSU Unit BStaff USA/MTAUndergraduate student employees

Last Updated

Document last updated on November 7, 2024

Downloads

  • 101 - if out more than 5 days (R) 02-03-2023_0.pdf

Size

1.5 MB

Pages

Workers' Compensation

Leaves of Absence
  • Workers' Compensation

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