Emergency Injury

1. Go to the nearest emergency room.
2. Report the injury to your supervisor as soon as possible.
3. Follow the instructions under Non-Emergency Injuries.

Non-Emergency Injury

1. Immediately report the injury to your supervisor: Your supervisor will give you a Request for Medical Service form and a Workers' Compensation Claim form.

2. Obtain medical treatment:
   • If you have a Pre-designated Physician form on file prior to the injury, you may obtain treatment with that physician.
   • If you do not have a Pre-designated Physician form on file prior to the injury, you must select a Primary Treating Physician from the Request for Medical Service form. You do not need to make an appointment for initial treatment. Give the Request for Medical Service form to the medical provider.



3. Complete the Workers' Compensation Claim form and return it to your supervisor.

4. Provide a work status slip from the Primary Treating Physician to your Supervisor. This is the employee's responsibility after every medical appointment!