Section 300
Proc. 397
Subject: Workers’ Compensation
Effective: 7/1/78
Revision (11): 09/01/2016

A reportable occupational injury or illness is one which requires the attention of a physician. The employee should report the injury or illness to the supervisor and the supervisor to the Human Resources Office as soon as possible. State law provides that the employer must be notified within 30 days of the injury or illness or Workers’ Compensation benefits may be denied. The following actions shall be taken in cases of reportable occupational injuries and illnesses:

Workers Compensation Claim Procedure
TO FILE A CLAIM – if medical treatment required

Steps to follow:
1. REPORT the accident/injury to your supervisor immediately.

2. You and your supervisor shall call the Workplace Injury & First Notice of Loss (FNOL) Call Center at 1-866-245-8588, option #1, immediately after the occurrence of the incident. The injured employee will speak with a 24/7 registered nurse to evaluate the nature of the injury and determine immediate care or treatment options. If medical treatment is recommended, the nurse will direct the employee to the nearest State-approved medical provider. The State will not pay any medical expenses you incur from a physician not in the network. Call 911 for Medical Emergencies.

3. To complete the reporting process your supervisor can ask the registered nurse to transfer the call to the First Notice of Loss (FNOL) Unit, or directly call 1-866-245-8588 and select option #2. If you prefer, the Human Resources personnel can call and complete this process once they receive the “Incident Report” from the employee/supervisor.

4. EMPLOYEE AND SUPERVISOR MUST COMPLETE AND SIGN the “Incident Report” immediately and return it to the UTSI Human Resources office.

5. Employee and supervisor must read the Workers’ Compensation Instructions/Procedures handout and sign the cover sheet stating they have received and read this document. This is required by the State Division of Claims.

FORMS TO COMPLETE: (return to UTSI HR asap)
1. “Incident Report”
2. Employee and Supervisor Instructions (employee and supervisor must sign cover sheet)

PRESCRIPTIONS: If the injured employee might need a prescription, please stop by the UTSI HR office for a “First Fill” form to take to a participating pharmacy. This form allows the employee to fill initial prescriptions with certain limits at no cost to them.

If claimant should employ an attorney, only a Board of Claims attorney should respond to questions or comments from either the claimant or the claimant’s attorney. Advice on handling these types of situations may be obtained from the UTSI Human Resources Office.

If questions or concerns, please contact the UTSI Human Resources Office, ph: 931-393-7226 or ext. 37226.