**Claim Filing Procedures for ALL Employees**
For information regarding student injuries, please contact the Business Office Clerk
A few points to remember:
1. Reports of injury (whether the employee provided verbal or written notification) should be sent to Tina Cruz immediately. You can call her at 708-863-4856 ext. 68091 OR email her at firstname.lastname@example.org and she will follow up to obtain the necessary paperwork. Verbal notification of an injury by an employee is OFFICIAL NOTFICIATION and should be taken seriously. Whether the employee wants to complete paperwork or not, the accident/injury/incident must be reported to Tina Cruz.
2. A full duty release is required when outside medical treatment has been sought. THE RELEASE MUST BE PRESENTED TO TINA CRUZ BEFORE THE EMPLOYEE CAN RETURN TO WORK.
3. The appropriate paperwork is linked up at the top. Effective immediately, please only use those forms and dispose of any old reporting forms.
Workers' compensation reports must be filed for all injuries/incidents that Cicero School District 99 employees are involved in. If an injury was sustained due to an incident/accident, by a staff member while in the process of fulfilling job duties for District 99 (which may or may not be on District 99 property), reports must be completed and submitted by the staff members and supervisors involved.
The employee and/or supervisor must call or email Tina Cruz as soon as the accident happens or is reported. As much detail as possible should be conveyed so that she may complete the necessary paperwork and report the claim to our third party administrator. The sooner a claim is reported, the better, as DELAYS IN THE REPORTING MAY HINDER THE CLAIM.
Once the employee's immediate supervisor has been notified, the injured employee must then complete the following forms: WC Employee Injury Report, Authorization For Release of Health Information, and Injured Workers Responsibilities.
Once the employee's immediate supervisor has been notified the supervisor must then complete the WC Supervisor Report. The purpose of the Supervisor's report is to get a different point of view on the injury and to seek discrepancies in reporting. SUPERVISORS MUST COMPLETE THE REPORTS THEMSELVES AND IN THEIR OWNS WORDS. Once the report is completed, the supervisor then ascertains if there were any witnesses to the accident.
If there are witnesses to the accident, the supervisor must ensure that the witness completes the WC Witness Report.
If the injury warrants, the injured employee may seek medical treatment at Woodlake Occupational Health, the nearest healthcare facility, or the healthcare facility of their choice (their own doctor). PLEASE REMEMBER THAT A FULL DUTY RELEASE IS REQUIRED WHEN MEDICAL TREATMENT HAS BEEN SOUGHT.
If a claim is accepted, all medical bills should either be sent directly to the IPMG claim administrator handling the case, or brought to Tina Cruz at the administration building. The appropriate mailing address for the claims administrator is: IPMG 225 Smith Road, St. Charles, IL 60174. Phone: (877) 616-0504. Fax (630) 587-7755
All workers' compensation injury reports (Employee, Supervisor and Witness reports) must be received by Tina Cruz WITHIN 24 HOURS OF THE ACCIDENT/INJURY/INCIDENT. It is preferred that the reports are scanned and emailed followed by the originals sent via interschool mail.
If the reports are not submitted in their entirety within 24 hours of the accident, an injured staff member runs the risk of a lengthy inquiry and/or a POSSIBLE DELAY IN ANY SALARY REIMBURSEMENTS for time off due to the injury (should IPMG determine salary reimbursements are necessary).
Any claim forms that are INCOMPLETE will be sent back to the individual, which will further delay processing of the claim.
Please remember that there is no guarantee that a claim will be accepted. However, a report must be completed for any injury occurring at the workplace and all injuries will be investigated. Although a report must be completed for all injuries, please remember YOU are responsible for all your actions at the workplace and are expected to apply safe work practices.
If you have any questions regarding workers compensation, please contact Tina Cruz at (708) 863-4856.
Thank you for your cooperation.