An employee who sustains a work-related injury or accident shall be presumed eligible for worker's compensation and should seek the worker's compensation benefits to which he/she is entitled by law. The Board of Education will permit, in accordance with law, the absence without loss of pay or of annual or accumulated sick leave benefits for the injured employee. Any employee who qualifies for work-related disability pay under this policy shall receive full pay during the period he/she is on disability leave of absence, up to one calendar year.
Reporting Procedures: Employees who sustain work-related injuries must immediately notify their building principal or department supervisor and school nurse. The school nurse or injured employee should contact the worker's compensation provider First MCO at 800-831-9531. First MCO will direct the injured employee to a medical facility, if it is not a medical emergency.
All work-related accidents must be reported immediately to the Building Principal or Supervisor and the School Nurse, who will assess the injury and provide immediate care as needed.
Why you should report all injuries: Even minor injuries can lead to complications over time. Prompt reporting ensures timely access to treatment and proper documentation, which helps protect your health and benefits. Delayed reporting may impact your ability to receive care and coverage.
The School Nurse will initiate the call: The school nurse will contact First MCO at 800) 831-9531 to report the injury.
The Employee will provide personal information: Once the call is initiated, the employee will speak with a First MCO specialist to provide the required information, including:
Name, address, and telephone number
Date of birth and Social Security Number
Details of how the incident occurred and the injuries sustained
Date of hire, hours worked, and salary
Employees must make note of the incident number provided by the FMCO specialist at the time of reporting. This incident number should be recorded on all related paperwork and retained for personal records.
The First Report of Injury is transmitted electronically to Inservco by the FMCO specialist. Inservco establishes the claim, assigns a claim number, and automatically forwards this information via email to the Office of Human Resources.
The School Nurse will provide and collect the following required forms to submit to Human Resources: In some cases, you may also be asked to also complete a Worker’s Comp Medical Release Form.
Employee's Accident Report: Complete, sign and return to the school nurse on the day the injury is reported. This paperwork must be left with the school nurse.
Supervisor's Incident Report: Must be signed by a principal or supervisor.
Witness Report: Completed by any witnesses, and may not be distributed to the witness by the employee.
What if no treatment is required? The case is reported only. An employee usually does not need to bring paperwork for treatment.
First MCO will direct an injured employee to a medical facility.
Should the injury be life-threatening you should report to the nearest hospital emergency room. Following treatment in the Emergency Room, call the school nurse so the report of injury can be made with First MCO and further care will be directed.
In all cases, First MCO will manage an injured employee’s care, referring them and making their appointments when necessary with specialists as well as following up to monitor the improvement of their medical condition.
What is the preferred Urgent Care Facility? Doctor’s Express (AFC Urgent Care); Address: 67 E. Ridgewood Avenue, Paramus, NJ (7-Eleven strip mall across from Lord & Taylor in the Fashion Center).
If the injury occurs outside of the regular school day, staff should contact FMCO directly
Call the toll-free number (800) 831-9531 directly.
First MCO’s toll-free number available 24 hours, seven days per week.
Alert the Office of Human Resources immediately on the next work day.
Can I treat with my own doctor? No. All injured employees are directed to treat with the physicians and facilities in our network, as directed by the First MCO nurse case manager or Intake Specialist. In certain circumstances, an evaluation may be allowed. An example of this is a pregnant injured worker: they may want to be evaluated by her own OB/GYN. Another example may be a dental injury: the employee may be allowed to see his/her own dentist. One more example could be an injured worker who recently had surgery and the injury was to that same body part. All treatment must be authorized by the nurse case manager.
Do I have to go for treatment right now, or can I wait to see how I am feeling in the morning? (New Claim) It is okay to wait for treatment or deny treatment. However, all claims must be called into First MCO’s 24/7 injury report line 800-831-9531.
What if the injury occurs after hours? Call the toll-free number (800) 831-9531 directly. First MCO has 24/7 claims reporting coverage. The intake department is open from 8:15 AM to 4:15 PM, Monday through Friday. After hours and weekends an ON CALL Service will receive the call. The service in turn contacts the First MCO nurse immediately, and a telephone call is returned within 5 minutes. Any emergency or injury threatening life or limb - you should call 911 for assistance and then call First MCO.
Can I go for treatment or physical therapy during work hours or do I have to use my own time? This is completely up to the employer and whatever policies they have at their facility. First MCO can enter special instructions, per employer, into our system. We will customize our appointment referral times to meet your needs, whenever possible.
What if the doctor puts me back to work but I do not feel up to it? The nurse case manager will individually evaluate the situation, discuss the case with the claims adjuster, and may suggest a second option. First MCO may also bring the issue to their Medical Director for review. However, this is not the norm and most often the employee would be directed that he/she may remain out of work, but may not receive compensation benefits. These claims are referred to the Third Party Administrator for further investigation and resolution.
Disclaimer: The information does not change or alter the coverage provided under workers’ compensation and is meant for informational purposes only. Always check with your managed care or claims provider for clarification of claim or managed care questions.