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The Texas A&M University System Workers’ Compensation Insurance (WCI) Program was created by the State of Texas to provide reasonable and necessary medical coverage and indemnity payments to employees who sustain injuries or occupational diseases while in the course and scope of their employment.

Employees who suffer an injury or illness as a result of and in the course of employment should immediately notify their supervisor. The employing division then has the responsibility of contacting Engineering Human Resources by submitting needed forms.

Fill out the First Report of Injury through the Origami reporting module or submit paperwork to Engineering Human Resources via fax at 979-458-7490 or hand deliver to Zachry Engineering Education Complex, Suite 531.

Forms

A First Report of Injury or Illness is to be completed online by the employee’s immediate supervisor or authorized division representative and submitted with the Witness Statement, if available, within 24 hours of the injury/illness. Reporting is generally completed online through the Origami reporting module.

  • Employers First Report of Injury or Illness (Origami Reporting Module)
  • Injured Worker Rights and Responsibilities information will be given to an employee who reports a workplace injury.
  • Request for Paid Leave will be submitted to Engineering Human Resources as soon as the supervisor becomes aware that the employee is losing time due to a work-related injury. If the employee is unavailable for signing, the form may be completed by the supervisor after consultation with the employee.
  • Supplemental Report of Injury or Illness (DWC 6) accounts for any period of time lost from work for which the injured worker might be entitled to Worker's Compensation benefits. This document also serves as written notice of an employee’s time lost from work and return to work after a period of temporary disability or of any change in pay status.
  • Wage Statement (DWC 3) is required when the employing division knows or should have known an employee will miss more than seven days cumulatively for a work related injury.
  • Bona Fide Offer of Employment

Safety Reporting

In addition to filing the First Report of Injury or Illness with Engineering Human Resources, accidents and injuries that occur in an Engineering building or facility are to be reported online.