Workers' Compensation Claims

Any Berkley School District employee is requested to complete an Employee Injury Report form any time there is an injury (even if medical care is not required).

It is essential that this form is completed, signed by the building administrator and forwarded to Barb Tombrillo as soon as possible after the incident. Information must be relayed to our insurance carrier on a timely basis. Be sure to provide as much information as possible (what the employee was doing just prior to the incident, details of the incident, time and place of the injury) to help expedite the filing of a claim, if necessary. Please see your building secretary for a form or click on the folder below. If you have any questions regarding an injury, please contact Barb Tombrillo at 248-837-8029.

Word DocumentEmployee Report of Injury