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.
What information does employees need to provide employers?
The injured employee's supervisor will need the following information to report a work-related injury:
- Name, address, telephone number
- Date, time and place the injury occurred
- Description of the circumstances and the nature of the injury
- Names of any witnesses
- Information of treating physician
Who will file this information and handle the claim?
The injured employee's supervisor will work with CCMSI to ensure all proper forms are completed and filed with WCI.
The University of Texas System Administration employees
If you are an employee at The University of Texas System Administration, please contact Amy Lee at 512.499.4645.
What forms are required to claim workers' compensation benefits?
If an employee has lost time from work due to a work-related injury, a Notice of Injury and Claim for Compensation Form (NICC) from The Department of Insurance, Division of Workers' Compensation (TDI/DWC) must be completed immediately and mailed directly to TDI/DWC.
Failure to report a work-related 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
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