First Report of Injury

  •  

    All work-related injuries should be reported as soon as possible to the Benefits Office at 469-948-8071. 

    This form should be filled out even if the employee does not plan to see a doctor.  This protects the employee such that if they need to see a doctor in the future the injury has been reported.

    The employee should fill out the Employee's First Report of Injury or Illness and return the form to the nurse or secretary on the campus who will fax/e-mail it to the Benefits Office.  Pages 2-6 are to be given to the employee for use at the doctor's office (page 2) and pharmacy (page 3).  The employee must see a doctor who accepts Workers' Compensation and must not use their personal health insurance.

    Our third party vendor for Workers' Compensation is Claim Administrative Services, Inc.They can be reached at 800-765-2412.

    View Document

  • Phone Icon 469-948-8071
    Fax Icon  972-350-9360