Employee Forms and Resources

NOTICE TO EMPLOYEES INJURED ON THE JOB

In compliance with Board policy 5.27.4, procedures related to employees injured on the job must be strictly followed in recouping medical expenses or reinstatement of sick days if absences are incurred due to the injury. Failure to follow guidelines established could result in a denial of your request.

EMPLOYEE INSTRUCTIONS:

1. Notify your immediate supervisor within five (5) days of the injury occurring. If clinically unable to make notification, another person reasonably knowledgeable of the incident may make notification of the injury. A Hoover City Schools Employee Injury Form must be completed for all employee injuries and signed by the employee and the supervisor. The form may be found on the website. The report must be submitted to the Human Resources Department for documentation.

2.  If medical attention is required due to an injury, the Board requires completion of a Physician Certification Form to certify that the employee’s injury would not allow them to return to work within five working days of filing the On-the-Job Injury Report, unless hospitalization or special circumstances exist and the supervisor is notified. This form must be submitted to your supervisor when completed. Upon determination that an employee has been injured on the job and cannot return to work as a result of the injury, sick days shall be reinstated for a period of up to ninety (90) working days. If an employee is eligible for leave under the Family Medical Leave Act (FMLA), FMLA will run concurrently with the days missed associated with the injury. Verify that your supervisor submits a written request to reinstate sick days as OJI to the appropriate Executive Director of Human Resources (maximum of 90 days for OTJI sick day reimbursement). Recertification may be required for intermittent absences.

3. If out-of-pocket medical expenses are incurred due to an injury, employees of the Hoover Board of Education have the right to file a claim with the State Board of Adjustment requesting reimbursement. This claim must be submitted no later than one year from the date of injury due to the statute of limitations. If ongoing treatments are necessary beyond the first year, employees must submit a claim each year to seek reimbursement. Hoover City Schools is not affiliated with the State Board of Adjustment; therefore, IT IS THE EMPLOYEE’S RESPONSIBILITY TO FILE A CLAIM. To review the Rules of the Alabama Board of Adjustment and obtain claim forms, please visit the Board of Adjustment website.

Revised  12/2025

Download the On the Job Injury Report Form (PDF)

Download the OTJI Physician Certification Form