Accident+Report

Accident Report:

WORKERS’ COMPENSATION BENEFITS AND PROCEDURES Reporting Process: 1. Injured employee (claimant) reports the injury to his/her immediate supervisor; 2. Claimant completes the most current __Employee’s First Report of Injury__ form; 3. Fax completed __Employee’s First Report of Injury__ form immediately to the Insurance and Risk Management Office at **613-6169** (with or without both signatures); 4. Send through district mail the completed and signed original Employee’s First Report of Injury form to the Insurance and Risk Management Office in Human Resources. The most current __Employee’s First Report of Injury__ form is available from the school or department secretary or from the Insurance and Risk Management Office at 613-5003. It is also available on First Class (District>District Resources>District Forms>Insurance & Risk Management>Workers’ Compensation>1st Report of Injury.doc.) **__See Link below__** ** DESIGNATED PHYSICIANS ** The district has designated two medical clinics to treat workers’ compensation injuries. If an employee is injured on the job, he/she must be treated at either **WorkWell Occupational Medicine or Banner Occupational Health Services** in order for the medical expenses to be considered eligible and, ultimately, payable by the workers' compensation carrier. **Treatment by any other medical provider will not be considered authorized and the injured employee will be responsible to pay for the cost of medical treatment.** ** WorkWell Occupational Medicine Banner Occupational Health Services1608 Topaz Drive 1703 East 18th Street, Suite 4, ** ** If the injury is life or limb threatening, emergency care can be provided by: ** ** McKee **** Medical Center ** ** 200 Boise Avenue ** ** Loveland ****, CO 80538 ** Follow up care must be provided or directed by one of the designated physicians at **WorkWell Occupational Medicine** or **Banner Occupational Health Services**. **__Please make an appointment with one of these offices within 24 hours of emergency room or hospital visit__**. ** Referrals ** are at the discretion and expert medical opinion of the designated physician.
 * All injuries must be reported to the Insurance and Risk Management Office within 24 hours of the injury. ** Each day of delayed reporting beyond that time frame could result in a penalty of one day of compensation as determined by the Colorado Workers’ Compensation Act.
 * Loveland ****, CO 80537 Loveland, CO 80538 **
 * (970) 593-0125 (970) 278-4580 **
 * Additional Information: ** Contact the Insurance and Risk Management Office by phone at 613-5003 or by fax at 613-6169.