Workers Compensation

All injuries that occur on work time and any illnesses that occur as a result of something that happened at work must be reported to your supervisor IMMEDIATELY.  If the situation is not an emergency, you must complete and submit the Employee Incident Report - Employee Statement and Certification form immediately.  Your supervisor will use this to complete a First Report of Injury form for you to sign and then s/he will fax it to the workers' compensation carrier.  After the form is faxed, you may coordinate any care you need.

You must coordinate any non-emergency workplace injuries or illnesses requiring medical attention beyond first aid with the workers' compensation carrier in either of two ways: 

• • An approved provider in the workers' compensation carrier's network (called a "Gatekeeper ") can coordinate your care. 

  • A claims service representative, an adjuster, or a nurse triage manager may provide guidance for your care if you call 1-866-367-5226. 

Be sure to tell the person who answers that the form was already faxed and you are NOT calling with a first report.  

Anytime an employee reports a workplace injury or illness to you, you must direct her/him to complete and submit the Employee Incident Report - Employee Statement and Certification form immediately. All items on this form must be complete. Using the information on this form, you must also complete the First Report Form IA form (preferably by selecting the "Workers Compensation" workflow in AdobeSign and following the wizard), have the employee sign it. and then you fax it to the carrier.  Lastly, you must complete Employee Incident Report - Supervisor Statement and Certification form.

If the situation is an emergency, please ensure the appropriate care is provided before you complete the forms. Otherwise, please complete the forms and instruct the employee to coordinate care though a Gatekeeper or the workers' compensation carrier.

See Incident Reporting Forms.

To find a Gatekeeper:

Call 1-866-367-5226 and ask for assistance finding a Gatekeeper, call your preferred provider to confirm that s/he is a Gatekeeper, or use this site to find a gatekeeper and may be covered under NKY Health's workers' compensation plan:

https://www.bhnmanagedcare.com/

To find a Pharmacy:

Use this site to find out if a specific pharmacy provider or to find a list of pharmacies who may be covered under NKY Health's workers' compensation plan:

http://www.preferredmedical.net

Address for reporting injuries, submitting claims, and following up on care:

Bluegrass Health Network - KACO

PO Box 436499

Louisville, KY 40253

Phone: (866) 367-5226

Fax: (502) 489-6430