YOUR SERVICES: Reporting Claims

If your employee’s need for treatment appears urgent - for example, bleeding profusely, unconscious or maybe having a heart attack – get them to the nearest emergency room or call 911.

You must give the employee the State Claim Form for Workers’ Compensation Benefits (see state forms below).

According to the law, this form must be given to the employee in person or by first class mail within 1 working day of finding out about the on-the-job injury. Once the employee returns the form, you have 1 working day to complete your portion and send it to ICW Group. Keep a copy for your records and provide one to your employee.

California employers - approve treatment at a Medical Provider Network (MPN) facility within 1 working day after you receive the claim form from your employee.

Complete the State Form for "First Report of Injury or Illness"

See the state forms below. You have 5 days from your knowledge of the work-related injury or illness to submit this form to ICW Group. Postponing can cause the delay in benefits and unnecessary anxiety for your employee.

Report any serious injury / illness, or fatality to OSHA within 8 hours.

If not, you may be penalized! For example, the minimum citation for failing to report the incident to OSHA (and Cal-OSHA in California) is $5,000.

Report to: 800.321.OSHA (800.321.6742)

See these helpful links:

• Reporting Serious Injuries & Fatalities to OSHA
• mySafetynews.com: OSHA Fatality and Serious Injury Reporting Requirements

Communication is the best way to manage your claims. Always contact your Examiner when a work status changes, the injured worker may be working elsewhere or involved in recreational activities, the availability of modified work changes for any reason, the injured worker is terminated, or has changes in their rate of pay.