Workers' Compensation Reporting Procedures
If a paid Stetson employee is injured while in the performance of their required work duties, the employee should notify their Supervisor immediately. Risk Management should then be notified ASAP so the work comp claim can be processed and authorized medical treatment can be arranged with a work comp approved provider if/when needed.
Accident Report Forms
If the above work-related injury occurs, please complete and sign the appropriate Employee Accident Report Form. (The Supervisor should review the form and sign off as well)
There are Two Accident Report Forms
Please print out the appropriate form, then complete and sign. Signatures must be hand-signed and dated or digitally signed with authentication.
Per the Florida State Workers' Compensation Statute, work-related injuries should be reported to the Employer as soon as possible by the Employee. If reported later than 30 days, the claim can be denied.
Once the Employee Accident Form is completed, send the completed form to Risk Management so the injury can be reported to our Workers' Compensation insurance carrier.
Workers Compensation Contact Information
Primary Contact: Elise Paulson
Location: Administrative Services Building, corner of N Amelia and E Wisconsin Avenues
NOTE: Scan/Email is recommended submission format. This allows our staff to recieve notice of injuries even while out of the office.
Workers' Compensation Authorized Medical Treatment
Serious Injuries/Emergency Treatment
If an injury is serious and requires immediate emergency treatment, call 911 and/or Public Safety at 386-822-7300. Notify Risk Management ASAP. (Email: email@example.com / Phone: 386-822-7701)
General Medical Treatment
If an employee needs medical treatment that is not an emergency, Risk Management will obtain authorization from the Work Comp Insurance Company for the employee to go to a work comp approved primary care provider. There are several in the near vicinity that the employee may choose from, and the list will be provided by Risk Management. Most of them have extended hours in the evening and on weekends.
If a work-related injury occurs during an employee's work-shift that is after normal business hours or when campus offices are closed, they should notify their supervisor and call Public Safety immediately. The Employee Accident Form (above) should be completed and submitted to Risk Management as soon as possible so the claim can be reported to Workers' Compensation on the next business day. Medical treatment will then be arranged with a work comp doctor if needed.
(If campus is closed for the holidays, please ask Public Safety to contact Risk Managment.)
Public Safety can assist with First Aid if needed. If the employee needs medical treatment beyond first aid that cannot wait for Risk Management's return the next business day; the employee may go to a nearby Emergency Room for treatment (typically that is Florida Hospital DeLand). They should notify their Supervisor (or Public Safety) that they are going to the ER and advise which one. If the injury is serious and requires emergency medical treatment or ambulance, Public Safety should be notified ASAP (386-822-7300).
If ER asks about insurance, Employee should advise the ER that the injury is work-related and give them the Stetson Risk Management Contact Info so they can obtain our workers' compensation billing info. (do not pay a health insurance copay).
Please notify Risk Management of any ER medical treatment ASAP (Email: firstname.lastname@example.org or Phone: 386-822-7701 and leave a message if not in)
NOTE: Risk Management will need the ER discharge paperwork to send in with the workers' compensation claim. Any follow up medical treatment required will need to be arranged with a workers compensation medical provider and authorized by the workers' compensation insurance company.
If you have any questions regarding Workers' Compensation, please contact Risk Management:
Email: email@example.com / Phone: 386-822-7701