Workers' Compensation
Worksite accidents and injuries can occur in spite of everyone's best efforts. Although everyone strives to minimize on-the-job accidents, they can happen. If an accident or injury occurs, and you would like to file a Worker's Compensation claim, please follow these procedures to assure that you or your employee receives prompt medical care and that the Worker’s Compensation Claim is filed.
If the injury is life threatening, please seek prompt medical care and proceed later with claim reporting. Please go to the nearest hospital ER or urgent care facility and inform them that you are seeking treatment for a potential worker's compensation injury.
For all other injuries, please follow these steps:
1) Notify your supervisor
Notice can be given verbally (over the phone or in person) or in writing but by law, it must include all of the following: date, time and location of the injury. You should also include a brief description of the accident and the injury sustained.
2) Report your accident to the Gallagher Bassett Risk Management Early Intervention 24-hour Hotline at 1-833-891-1372.
Gallagher Bassett Services is the administration of the Illinois State Employee Workers' Compensation (WC) Program. Gallagher Bassett is a third party administrator who provides claims administration services to corporate and governmental entities across the United States. Gallagher Bassett monitors and evaluates the care received by the injured employee to assure appropriate treatment and optimal return to work
a) Provide your full name and your current mailing address, and that you are an employee of SIUE.
b) Inform Gallagher Bassett of the physician and/or facility information you use if you plan to seek medical treatment.
c) Print the Worker's Compensation Employee Packet below and if possible, take it with you when you seek medical care. The packet is important and includes Gallagher Bassett’s medical expense billing address which should be given to the medical care provider.
3) Report your accident to the SIUE Workers’ Compensation Coordinator:
Southern Illinois University Edwardsville
Human Resources
Tayanna Crowder, Benefits Counselor
Campus Box 1040
Edwardsville IL 62026
618-650-2190
tcrowde@siue.edu
If you have not obtained the Workers' Compensation packet, we will mail one to you. The Worker’s Compensation Coordinator can assist you with questions you may have.
4) Complete an Emergency Management Services Injury Form.
Submit an Incident Report to SIUE Environmental Health & Safety.
Additional important items to remember:
If you require medical treatment and it is not an emergency, contact your primary care doctor or medical provider. Please inform them that you are seeking treating for a potential Workers' Compensation injury and remember to bring the Worker’s Compensation Employee Packet so that your medical provider can forward medical bills to:
Gallagher Bassett
PO Box 2934
Clinton, IA 52733-2803
Fax: 1-847-621-7101
Please be aware that your WC claim is still pending until Gallagher Bassett approves the incident as a covered Worker's Compensation event. Gallagher Bassett cannot determine if the accident or injury is covered by Worker’s Compensation coverage until they receive your completed claim forms. If Gallagher Bassett does not approve the incident, you are responsible for your own medical expenses.
If your doctor places you off work or on any form of restricted work, you will need to provide a written Work Release (Return to Work form) from your doctor. The Work Release or Off Work Notice must be signed by the doctor. If you need a workplace accommodation to return to work, we will communicate your needs with your department. Your department must determine if they can accept the accommodation and for the duration requested.
Employees who file a Workers Compensation Claim may not be retaliated against.
Failure to follow these procedures may affect the employee's right to compensation for time lost or reimbursement for expenses incurred.
The following packet must be completed to establish a Workers' Compensation claim:
The following presentation gives basic information on Workers' Compensation:
