The Claims Process
At HEMIC, we know that employees need to be healthy, businesses need to be productive, and medical providers need to be free from needless paperwork.
If you have been injured on the job, seek appropriate medical treatment right away and report the injury to your employer immediately. They need to let us know that you’ve been hurt by submitting a WC-1 Employer’s Report of Industrial Injury. Then, your personal Claim Specialist will call you within 24 hours to start helping with your claim.
We will work as a team with you, your employer and your medical provider to treat your injury, resolve your claim, and get you back to work as soon as possible.
Your employer needs to submit the WC-1 Report, not you. If your employer doesn’t submit the WC-1 Report, you can contact the Department of Labor and Industrial Relations and submit a WC-5 Employee’s Claim for Workers’ Compensation Benefits with them. They will notify your employer and us, and make sure that a WC-1 gets submitted.
If you’re injured at work, here’s what you need to know:
- Get medical treatment. If you do not have a medical provider, go to the nearest Emergency Room, Urgent Care or other appropriate medical facility.
- Your employer should send us a WC-1 Report within 24 hours after they become aware of a workplace injury.
- Within 24-hours of receiving the WC-1 Report, your personal Claim Specialist at HEMIC will call to talk with you about your injury, your medical treatment, and any treatment that might be anticipated. They will also discuss your “Return to Work” or “Off Work” status as a result of the injury.
- If the doctor treating you gives you an Off Work Disability Certification, give this to your employer, who will provide this information to your personal Claim Specialist.
- Your Claim Specialist will ensure that reasonable and appropriate medical treatment is approved and provided by your doctor to help you recover in a timely manner.
- You can change doctors as long as the new doctor is qualified to treat your accepted injury or illness. Generally, you are allowed to change doctors once. Your Claim Specialist will need to approve your transfer to a new doctor.
- If you lose time from work due to your injury, a portion of your loss wages will be determined and promptly paid by your Claim Specialist based on the Off Work Disability Certification from your treating physician.
- Loss time from work only pays 66 2/3% of your loss wages up to a specified maximum. Returning to work when you are able will preserve your earning power and financial stability.
- Remember, this is a team effort between you, your physician, and your employer. Stay in touch with them for a timely return to work.
If you are injured on the job…
Report workplace injuries to your employer immediately.
Seek medical treatment from your medical provider or closest emergency room.
Your employer will complete a WC-1 Emloyer’s Report and send it to HEMIC within 24 hours.
Within 24 hours after receipt of the WC-1, an assigned Claim Specialist from HEMIC will contact you to discuss the workplace injury.