Workers' Compensation Reporting Procedures

Workers' Compensation Reporting Process 

Emergency Medical Treatment Required

  1. Call 911, follow their instructions and call Stetson Public Safety.
  2. Risk Management should be notified at this time.
  3. The employee receives medical treatment.
  4. Inform the EMS/ER staff that the injury/illness is workers' compensation-related and billing should be directed to Stetson University Risk Management and not to the employee’s insurance company.
  5. After medical treatment, the employee contacts their supervisors or department representative to notify them of the injury, if they are unaware.
  6. Complete the Workers' Compensation Incident Reporting Form and submit it to the campus workers' compensation contact along with all applicable medical records.
  7. A supervisor or department representative will complete a post-injury/illness assessment and provide a report to Stetson University Risk Management.

Non-Urgent Medical Treatment Required

  1. The employee immediately notifies their supervisor or department representative of the injury.
  2. Call Stetson Public Safety.
  3. Complete the Workers Compensation Incident Reporting Form and submit it to the campus workers' compensation contact.
  4. The employee receives medical treatment.
  5. During business hours, campus workers' compensation contact will authorize medical treatment at a facility approved by the University’s insurance company.
  6. Outside of business hours, the employee can seek medical care in the emergency room if the injury or illness cannot wait until the next business day. Inform the ER staff that the injury/illness is workers' compensation-related and billing should be directed to Stetson University Risk Management and not to the employee’s insurance company.
  7. A supervisor or department representative will complete a post-injury/illness assessment and provide a report to Stetson University Risk Management.

No Medical Treatment Required

  1. The employee immediately notifies their supervisor or department representative of injury.
  2. Call Stetson Public Safety.
  3. The employee signs Refusal of Medical Treatment Form which will be included in the Public Safety report.
  4. Complete the Workers Compensation Incident Reporting Form and submit it to the campus workers' compensation contact.
  5. A supervisor or department representative will complete a post-injury/illness assessment and provide a report to Stetson University Risk Management. 

Employee Responsibilities

  1. Employees must work responsibly, which means abiding by Stetson University and department specific safety protocols, policies, and procedures
  2. Report all work related injuries and illnesses according to Stetson University procedures
    1. Bloodborne pathogen exposures should be reported as a workers’ compensation injury/illness
  3. Seek medical attention from an approved provider if needed. If medical attention is not needed or wanted, a Refusal of Medical Treatment Form will need to be signed
  4. Respond to emails and phone calls from Stetson’s insurance carrier, FHM
  5. Provide a Florida Workers' Compensation Uniform Medical Treatment/Status Report Form to the campus workers’ compensation contact within one business day of each appointment

Supervisor Responsibilities

  1. Provide a safe work environment!
    1. Take the necessary steps to prevent injury and unnecessary exposure to danger
  2. Ensure campus workers’ compensation contact is aware any work-related injuries/illnesses sustained by your employees
  3. Confirm Public Safety has documented the incident. If Public Safety was not contacted, please contact them as soon as possible for them to complete a report
  4. Coordinate return to work options with the campus workers’ compensation contact
    1. If workplace restrictions are implemented by the treating physician, the supervisor will work with the campus workers’ compensation contact to confirm those restrictions can be accommodated
    2. The goal is to get all employees back to work as soon as safely possible!
  5. Provide return to work updates for the employee to the campus workers’ compensation contact
  6. Provide a post injury/illness assessment to Risk Management

Workers' Compensation Contact Information

Workers' Compensation Contacts – DeLand

Primary Contact - Elise Paulson
Email: [email protected]
Office: 386-822-7701

Secondary Contact – Vi Bumgarner
Email: [email protected]
Office: 727-562-7984

Workers' Compensation Contacts – Gulfport/Tampa

Primary Contact - Pam Skoularakos
Email: [email protected]
Office: 727-562-7807

Secondary Contact – Vi Bumgarner
Email: [email protected]
Office: 727-562-7984

Workers' Compensation Insurance Information

FHM Insurance Company
PO BOX 616648
Orlando, FL 32861-6648

888-346-3461 Ext. 6231

Policy Number: WC306-0020348-2023A 
Policy Holder: Stetson University