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How to file Workers Compensation claim
All employees that are not covered under the
Memorandum of Agreement with KCEA are
eligible to receive Workers’ Compensation
benefits. This includes custodians,
maintenance, food service, substitutes,
teaching assistants, security officers,
non-certified supervisors, interpreters,
and secretaries/bookkeepers.
In the event of a work related injury, the following
procedures must be performed:
-
If an employee’s direct
supervisor is not
available to complete
the following procedures,
it is the responsibility
of the employee to
contact the Employee
Benefits Department
at 594-1682 or 594-1686
to gain assistance
in completing these
procedures.
-
All accidents/injuries,
no matter how small
or insignificant,
must be reported
to an employee’s
direct supervisor
immediately.
-
Supervisors are responsible
for immediately notifying
the Employee Benefits
Office. If
practical, the C-20
Form should be filled
out immediately and
faxed to the Employee
Benefits Office at
594-3737.
-
If medical treatment is
required, an employee
must be seen by one
of the physicians
on Form
C-42G (Employee's
Choice of Physicians) in
order to be eligible
to receive Workers
Compensation benefits.
Form C-42G
(Employees' Choice
of Physician) and
Form C-31 (Medical
Waiver) must be completed
and faxed to the
Employee Benefits
Office at 594-3737.
An appointment will
be made for the employee.
Before a physician
on the panel will
see an injured employee,
they must receive
approval from the
Employee Benefits
Office.
-
After an employee receives
medical treatment,
the employee must
bring any doctor’s
notes and work release
to their supervisor
as soon as possible.
In the event that
a physician places
an employee off work,
the employee must
contact their supervisor
on each day they
are absent.
-
If an employee needs medical
treatment at a time
when the doctors’ offices
on the Workers’ Compensation
Panel are closed,
or if the Employee
Benefits Office is
closed, they may
go to any Knox County
hospital. The
employee must notify
their supervisor
and complete the
paperwork listed
above as soon as
possible on the next
working day.
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