Navajo Nation Workers Compensation Program

General Information

Employee's Responsibility:

Only duty is to report the injury to the supervisor and to the Workers' Compensation Program

  • Who was the injured
  • When did it happen
  • Where did it happen
  • How did it happen

Supervisor's Responsibility:

  1. Checks injury to see if the employee needs medical care
  2. Makes an initial inquiry/investigation
  3. Determines if witnesses were present
  4. Ensures that a Report of Injury form is completed immediately
  5. Files the Report of Injury form with the Workers’ Compensation Program

Required Documents/Forms include but are not limited to the following:
  • Report of Injury form
  • Navajo Nation Vehicle Accident form (if applicable)
  • Accident or police Report
  • Travel Authorization
  • Witness statements
  • Personnel Action Forms
  • Job descriptions
  • Shift, weekly, or monthly schedules
  • Official time sheets for the period of disability
  • Authorization for disclosure of medical information
  • Doctors’ statements
  • Medical return to work statements
  • Medical records
  • Medical referral notices



General Information (PDF)

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