Workers Comp

To insure proper management of a claim, please follow these  important steps:

Reporting an injury or re-occurrence  

· Report all injuries to  your supervisor, school nurse (or office) immediately or as soon as possible.

· Assist in providing detailed information to prepare the incident report for processing to the School Nurse. The incident will be reported to the insurance carrier via online submission and assigned a claim number (see sample submission form). 

NOTE:  A 24-Hour Reporting Hotline exists ( 1-800-652-4762) and is available should you become injured outside of normal school day work hours and no one is available to assist you.

Injury Requiring Medical Care

· You MUST seek medical care from our initial care providers:

Middlesex Occupational Center, 534 Saybrook Road, Middletown, CT.  PHONE:  860-358-2750

OR

MedWorks, 375 E. Cedar Street, Newington, CT.  PHONE:  860-667-4418

 If your injury involves:

  * time away from work

  * requires work restrictions

  * prevents you from returning  to work. . . . . . . . .

It is your responsibility to update your Supervisor with the appropriate documentation to remain under the Workers Compensation Program.

 Upon your return to work, or if you remain out of work, you must provide documentation with either a . . . . . .

Return-To-Work Note OR Authorization of Absence to your Supervisor/Director/HR:  

As a courtesy, a representative from CIRMA may follow-up with you to ascertain your progress and assist you with any questions.
Forms to give to doctor for Light Duty or any Work Restrictions:
- Custodial / Maintenance - WC temporary light duty limitations form
- All Other positions - WC Employee Medical & Work Status form

WC INJURY APPOINTMENTS / MILEAGE FORM

If you are attending a doctor's appointment regarding your injury due to WC, please make sure you are putting your time into Frontline/absence management (listing it as WC) and you are required to submit a doctor's note for that appointment to Human Resources (attn: Michele DiMauro) within three (3) days.

• Mileage form - if you need to go back and forth to WC appointments, you can use this form to keep track and get reimbursed for mileage directly from CIRMA. 

Injury Requiring a Prescription

Should your medical care require a prescription*, contact First Script at 1-800-791-2080.  Provide your claim number and date of injury. 

*Prior approval for a prescription requires no out-of-pocket expenses.  If an injury is out-of-district or after hours, please provide a receipt for reimbursement.

 Should you have any further questions, please contact :

Lynne McKenney at 860-632-4834 or Michele S. DiMauro at 860-632-6043

CIRMA directly at 1-800-526-1647