Workers’ comp What is the process and how do I complete the forms that are required with in the correct time frames.

What is the policy for reporting an injury at WCAP?

Some additional information from the Safety & Wellness Plan

What do I use the First Report of Injury Form for? This form is used to report an injury that you have incurred at work or a function that you were doing in a work capacity for WCAP

How do I fill this form out? It is simple! Complete every line and question that is on this form. This is the information that is asked when a claim is called into Maine Employers Mutual Company (MEMIC). In addition to what is on this form Human Resources also provides other information like your address and wages and such to MEMIC. The Questions that appear here are only the pieces about the event that we cannot get from another source.

What are the common errors that occur on this form? 1. Injury box is checked when it really is a report only 2. “What part and side of your body was injured?” This will be filled in with only the part of your body that was injured 3. “Site Location” is left blank 4. “Time you start work” This refers to what time you started the morning of the Report 5. “Do you work anywhere else” is commonly left blank *****Every line must be filled in*****

What is the Difference Between Report Only and Injury? Injury- an incident occurs and you are going to the doctors and/or you are losing time from work. Report only -an incident that occurs that you do not need to go to the Doctors and/or are not losing time, but could have a potential for either of those to happen in the future due to the incident.

We report everything, so that you can be protected! This is why you have a “Report Only” box on the form. In the event that a claim becomes medical or loss of time in the future.

What are additional forms I can use to assist me if I have questions?

This is also in your forms Binder This will help you to decide if it is an Injury or a Report Only. It will give you the time frames for reporting. How to you seek medical treatment if necessary. It is also the instructions on what to do as most of you are off site.

Mock Reports what they might look like

Report Only Scenario: Working with a child at lunch time, child was upset and started to throw toys and other items. Employee was hit on leg and arm. Causing bruising and pain. How do I fill out this form?

Injury Report Scenario: Working with a child at lunch time, Tripped over the rug landing on my arm and twisting my ankle. How do I fill out this form?

Questions?