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,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,Workers Compensation,Adjutant Generals Department,Procedures,11/17/2024,1,Process for Reporting a Work-Related Injury,Supervisor Promptly Notify State Human Resources Office,All reported incidents,When employee begins to lose time from work,Sustains a re-injury,Cant work within restrictions,Receipt of Doctors Notes,11/17/2024,2,Process(continued),Employees role,Immediately notify supervisor of on-the-job injury,accident,or illness,First aid or seek medical attention(Call(785)296-2364 before seeking treatment unless Emergency Treatment needed.),Complete,Employee Incident Report,Return medical report to Human Resources,Follow medical imposed work restrictions at work AND outside of work,Stay in touch with supervisor/HR,Work with departmental payroll person on lost time claims,Cooperate,HR,State Self Insurance Fund Contact,11/17/2024,3,Process(continued),Supervisors role,Make sure employee gets medical attention(call State Self Insurance Fund for prior authorization unless emergency),Dial 911 if injury is potentially life threatening,Complete,First Report of Injury,Forward medical reports/Dr Notes to Human Resources,Stay in touch with employee,Cooperate,HR,State Self Insurance Fund,11/17/2024,4,Process(continued),Seek medical attention,Emergencies:,nearest hospital,Burns:,nearest hospital emergency room,Eye Injuries:,nearest hospital emergency room or Ophthalmologist,11/17/2024,5,Process-,Employee,FORMS,Employee Incident Report,Complete,as soon as possible,following the incident,Forward to Supervisor,Supervisor sends to Human Resources,Medical Report/Dr.Notes,FAX or deliver a copy to Human Resources,11/17/2024,6,Process,Supervisor,FORMS,First Report of Injury,(paper or electronic version),Complete for ALL incidents,except minor incidents such as paper cuts unless develops into more serious injury,Complete within,8 business HOURS(1 day),Forward to Human Resources,11/17/2024,7,Process,Supervisor,FORMS,Give injured employee paper copies of:,W.C.Info Sheet,11/17/2024,8,HR Contacts,Marti Stadler,Tel.785-274-1392,FAX:785-274-1679,Jo Boswell,Tel.785-274-1391,FAX:785-274-1679,Stephanie Burdett,Tel.785-274-1460,FAX:785-274-1679,11/17/2024,9,State Self Insurance FundContacts,Main Telephone Number:,785-296-2364,FAX:785-296-6995,CORVEL Provider Search site:,11/17/2024,10,Questions?,Thank you for your time!,11/17/2024,11,
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