Employee must report any injury to his/her immediate supervisor before the end of shift.
Employee completes and signs Part A of the University Injury or Illness Incident Report and supervisor completes and signs Part B. Fax the form to extension 3650 or mail to Workers' Compensation, Department Satellite Office, Mail Stop #220 as soon as possible. This form must be completed to process any subsequent Worker's compensation claim.
If the employee needs medical treatment, he/she may obtain and claims filing packet from his/her supervisor, the Workers' Compensation Specialist, or download the form from the menu to the right.
Included in the packet are:
The Workers’ Compensation Specialist will require completion of the UT Injury or Illness Incident Report and may request more information from the Managed Care Organization (MCO)*, the employee, employee's supervisor, and/or the BWC prior to deciding whether to certify or reject the claim.
*The MCO will monitor the claim to ensure the employee receives timely and appropriate treatment. The University's MCO for main campus employees is: Paramount Preferred Network (PPN)/Health Management Solutions (HMS), 2525 N. Reynolds Road, Suite 4, Toledo, Ohio 43615, Phone: 419.530.5690, Fax: 419.536.7115.
If the injury is serious and requires immediate attention, go to an an emergency facility such as University of Toledo Medical Center, or Occupational Medicine Clinic formerly Medical College of Ohio Hospital.
If possible the employee should present the Paramount Preferred Network Worker's Comp Identification Card to the initial treatment facility.
We suggest choosing a provider certified by both the Bureau of Workers' Compensation and the employee’s health insurance carrier network, such as UT Occupational Medicine Clinic, which can be reached at 419.383.5403. Appointments can usually be made within 24 hours.
The employee should complete the worker and injury sections of the BWC FROI at the initial treatment facility. The attending physician who is responsible for the treatment section should return the form via fax to HMS (419-536-7115) within 48 hours of the injured employee’s initial visit. The employee may also personally deliver the FROI to the Workers’ Compensation Department Satellite Office. The completed FROI will then be sent to the BWC by the MCO to register the University's certification or rejection of the claim.
FROI can be downloaded from the Ohio BWC here.
The employee must use sick and/or vacation time to be paid for an absence due to work related injury or illness of seven (7) calendar days or less. From the 8th through the 13th calendar day of absence, the BWC will pay a portion of lost wages if the claim is approved. If absence is 14 or more consecutive calendar days, the Bureau will pay back to day one of the absence provided the claim is approved and injured worker did not elect to be paid sick time.
Once the supervisor knows an employee's absence will be greater than seven (7) calendar days due to work injury, he/she must notify the University's Workers' Compensation Specialist (Brenda Humberston 419.530.3655) IMMEDIATELY. Until the injured employee returns to work, all subsequent absence slips should be sent directly to the workers' compensation specialist by no later than the Wednesday of a non-pay week. This becomes critical to ensure proper pay for an injured employee. Any medical statements from the attending physician should be faxed to the Workers’ Compensation Department Satellite Office (419.530.3606) as soon as possible.
The employee may choose not to use the advancement program and simply go on unpaid leave or use sick time.
If the employee chooses to use the wage advancement program he/she must see the Workers' Compensation Specialist, NE 2350H, Phone: 419-530-3655. An advancement agreement must be signed, obligating the employee to repay monies advanced by UT, from the BWC payments issued to the employee. The agreement is faxed to the BWC. A maximum of 80 hours per pay period can be used for this purpose.
The sick/vacation time is held in escrow against the monies advanced in case the claim is denied by the BWC, the employee does not return to work or the employee defaults on payment of the advancement.
NOTE: The injured CWA worker must elect to either get sick pay for the first seven calendar days or sign a Wage Advancement Agreement. BWC rules prohibit the payment of both sick time and temporary total/wage advancement for the same period of time. Similarly the injured employee may not buy back his/her sick time. The Wage Advancement serves as an advancement to the injured worker while awaiting payment from the BWC.
Credit may be obtained at no cost to the employee or employer for any unpaid absence from work for a work-related injury by sending a release form to PERS or STRS authorizing the retirement system to secure the information from BWC for service credit only (no wage credit). The release form is available in HR.
The injured employee must obtain a medical release to return to work from the attending physician.
The injured employee must notify their supervisor if the treating physician has temporarily disabled them from employment or given work restrictions. The university will make every effort to provide for reasonable accommodations.
Work with restrictions is a temporary job assignment that allows an employee with an occupational injury or illness and has medically supported restrictions to return to work in some capacity. An example would be a person who has a lifting restriction that prevents him/her from prevents him/her from performing regular more physically demanding duties. Call Brenda Humberston for a more detailed explanation of RTW options.
| Workers' Compensation Department Main Campus Satellite Office Contact Information: | |
| Contact Person | |
| Brenda Humberston | |
| Mailing Address | Physical Address |
| 2801 W. Bancroft St. .. Mail Stop 220 Toledo, OH 43606-3390 |
1515 S. Towerview Blvd. 1410 Transportation Center Toledo, Ohio 43606-3390 |
| Office Phone | Office Fax |
| 419.530.3655 | 419.530.3650 |
*NOTE: Every effort has been made to assure the accuracy of information contained in this communication but in the case of employees governed under contract agreements that contract is the final authority.