Goose Creek Risk Management

Instructions for completing the Workers Compensation Report of Injury or Illness forms

The following are the reports which need to be completed on injuries.

  1. Supervisor's Accident Investigation Report - This report needs to be completed no matter if employee went to doctor or not. Please fax over this form to Wallace Vosloh at 281-420-4470. (Call Wallace Vosloh at 281-420-4838 or 281-420-4444 for Goose Creek Workers Comp. Identification Number before completing form)

  2. Employer's First Report Of Injury Or Illness TWCC 1 - This report has to be completed if the injured employee goes to doctor. Please fax a copies to Wallace Vosloh at 281-420-4470, Charlotte Pogue 281-420-5120 and after completing TWCC1 transmit to Texas Association of School Boards, Inc. at (800) 580 - 6720 Fax, Phone (800) 482- 7276.

  3. If employee goes to doctor send a Workers Compensation Identification Form with them.

  4. If employee goes to doctor give them a Workers Compensation Guidelines.

  5. If the employee is absent more than three days they must bring a return to work form back to the campus.

(COPIES OF THE ABOVE FORMS ARE ON THE WEB LINKS BELOW. THESE FILES REQUIRE ACROBAT READER.)

Supervisors Accident Investigation Report

Employer's First Report Of Injury Or Illness TWCC 1

Workers Compensation Identification Form 

Workers Compensation Guidelines

Return To Work Form

If you have any questions or need forms please call Wallace Vosloh at 281-420-4838.

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