How do I file a workers' compensation claim?
If an employee sustains injuries or an occupational disease as a direct result of employment, the employee must inform their supervisor immediately. For details on what information an employee must provide provide to a supervisor, please refer to Reporting an Injury.
Who will be handling my workers' compensation claim?
All workers' compensation claims are managed by a Workers' Compensation Insurance Representative in The Office of Risk Management Workers' Compensation Insurance office at The University of Texas System.
If I am injured on the job, what do I do?
Failure to report the injury within 30 days of the occurrence of the injury (or the manifestation of the occupational disease) may result in the denial of a claim.
If you are injured while performing work on behalf of your employer or if you acquire an occupational disease as a direct result of your employment, you should immediately inform your supervisor of the injury or disease. In reporting your injury, or occupational disease, you must provide your supervisor with the following information:
- Your name, current address and current telephone number.
- The date, time and place the injury occurred.
- A description of the circumstances and the nature of the injury.
- The names of any witnesses.
- The name of the doctor who has treated, or will treat you for the injury, if any.
Your supervisor will work with your employer's WCI Representatives to ensure that a First Report of Injury form is completed and filed with the UT System WCI Office. An adjuster in the UT System WCI Office will be handling your claim.
If you miss time from work:
- Your supervisor or your WCI Representative should receive written note from your treating doctor indicating you are unable to work. You must continue communicating with your employer throughout any period of disability unless you are physically unable to do so.
- You should receive a Notice of Injury and Claim for Compensation (NICC) form from the Texas Department of Insurance, Division of Workers' Compensation (TDI/DWC), along with instructions for completing the form. The NICC forms should be completed as soon as possible and mailed directly to DWC.
- You are expected to return to work as soon as you are physically able. If you are released to return to work by your doctor with restrictions, please work with your employer and your WCI Representative to comply with these restrictions.
- Your employer may have other specific rules for you to follow while missing time from work. Please communicate with your supervisor to make sure you are complying with any other policies.
- If you choose to miss work on your own without your treating doctor's order, your lost time, for purposes of calculating income benefits will be disputed.
If you require medical treatment for a work-related injury, you should immediately choose one treating doctor to coordinate your care. Tell your treating doctor that any bills for your work-related injury should be sent directly to the UT System WCI Office. Bills for services unrelated to a reported on-the-job injury should be sent to your regular health insurer or should be paid by you.
If your treating doctor has questions about the types of services that must be pre-authorized or about how to complete required reports and invoices, he or she may contact the Medical Review Division of the Texas Department of Insurance, Division of Workers' Compensation (TDI/DWC) by calling 512.440.3513.
Except in an emergency, if you receive medical care for a work-related injury which is not by or at the direction of your treating doctor, you may become responsible for payment of any charges associated with that care.
If it becomes necessary to change treating doctors for treatment of a work-related injury, you must complete a DWC-53 Form and get written approval from TDI/DWC before making the change. A TDI/DWC customer service representative can assist you with this process.
UT System WCI Office may, while your claim is pending, exercise its right to have you evaluated by a physician chosen by your claims adjuster. Such an evaluation will be done to determine if you are disabled due to your work-related injury and/or you have sustained any permanent disability due to your injury. If you are asked to see a physician chosen by the UT System WCI Office you will be given notice of the appointment at least ten days in advance.
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