Submitting a Workers Comp Claim or Incident
When an employee is injured in the course and scope of their work, their health and safety is our primary concern. Our response is dictated by the severity of the injury. The Risk Management Services website can guide you through the process and contains the necessary reporting packets. We can be contacted by phone at (940) 565-2109; fax (940) 565-4919; or email firstname.lastname@example.org.
Employees are required to notify their supervisors of any incidents or injuries they experience. The supervisor is then empowered to take appropriate steps, based on their initial evaluation of the situation. Although preferred, it is not always necessary or practical, to contact RMS before seeking treatment for the injured employee.
For severe or life threatening injuries – Call 911 if emergency, help is needed. Employees should be transported to either Texas Health Presbyterian ER or Med City Denton ER, depending on their preference. Upon arrival, the medical provider should be alerted that this is a work-related injury. The supervisor and employee should complete the Employee and Supervisor packets (See Below) and return them to RMS within one business day of the injury. RMS will confirm receipt of the information and follow up for any additional information needed.
For less severe or non-life threatening injuries – If no medical treatment is required, an Employee Injury Report (See Below) can be filled out. Supervisors should attempt to contact RMS, prior to directing the employee for medical care. Treatment for bumps, bruises, and minor cuts can be referred to the Student Health and Wellness Center (SHWC), even before RMS is contacted. Otherwise, employees can be seen at either Nova Medical Center or a local CareNow Facility. Refer to the links below for locations and contact information. Upon arrival, the medical provider should be alerted that this is a work-related injury.
- For injuries treated at the SHWC, the facility will call the supervisor directly for authorization and inform RMS of the treatment and authorization.
- For injuries treated at Nova Medical Center or CareNow, the facility will call RMS for authorization, unless authorization was given beforehand by RMS.
- For injuries that occur outside of RMS working hours (M-F, before 8:00 am or after 5:00 pm), supervisors should contact the third party clinics directly and authorize treatment for the injured employee. The supervisor will be asked to provide the injured employees full name, date of birth, last four digits of their social security number and the supervisor’s name and title.
In all situations where an employee receives medical treatment, the Worker’s Compensation packets must be completed and sent to RMS for filing the claim with the State Office of Risk Management. If no medical treatment is required, an Employee Injury Report (Incident Only) Form (eForm or PDF) should be filled out.
- Workers’ Comp Supervisor Packet
- Workers’ Comp Employee Packet
- Employee Injury Report (Incident Only) (eForm). PDF Employee Injury Report here. Please try to have these sent in within 1 business day of the injury.
- Los formularios están disponibles en español aquí.
PDF forms should be emailed to email@example.com using '#secure' in the subject line to ensure the email content is sent securely.
If an employee is on restricted/modified duties and/or schedule because of the injury, a supervisor must fill out a Bona Fide Offer of Employment that is in accord with the employees Work Status Report (DWC73) that they get from their doctor's visits. These should be filled out with assistance from a HR business partner.
UNT Risk Management will function as the primary coordinator for paperwork and information for ongoing claims. However, there might be certain questions that must be directed towards the State Office of Risk Management (SORM), CareWorks (TX HCN), or the healthcare provider's office