It is our
mission is to provide the highest quality service in a cost-effective
manner. Employers and employees all play vital roles in the
successful resolution of claims and mitigation of claim costs.
By working as a team, we can meet our goals in providing coverage
to our insureds and benefits to their injured employees.
Employers
Roles
Employees Roles
Claims Documents
Employers’
Roles
1. Promptly
report injuries to your HEMIC
representative.
Prompt reporting
is critical to a timely and accurate investigation, and ensures
the preservation of evidence and witness accounts of the incident.
When you report all injuries within 24 hours, we can:
2. Work
together with your HEMIC claim representative, your agent, our
in-house medical case manager, the injured employee and the
medical provider.
HEMIC believes
that teamwork brings about the most successful resolution of
the claim. The outcome should be a win-win situation for both
you as the employer and your injured employee.
3. Maintain
positive contact with your injured employee.
Your employee
will appreciate your sincere concern for his well-being and
recovery. Nothing aids the recovery process more than conveying
to the injured employee that he or she is wanted and needed
back on the job. Only you, the employer can convey this message
sincerely.
4. Develop
a Return-to-Work Light Duty Program.
Our claims
representatives work with the medical providers on appropriate
cases to release injured employees in a limited work capacity
until a full release is deemed appropriate. Employers with the
capacity and flexibility to accommodate these temporary restrictions
offer the injured employee the opportunity to contribute to
his company’s operations. Rather than letting the employee
languish at home when he or she is ready and willing to perform
limited tasks, the employer can help speed the recovery process
by engaging the employee in return-to-work activities. Contact
your HEMIC claim representative to help you set up such a program.
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Employees’
Roles
1. Report your injury to your supervisor immediately.
Prompt reporting
of your injury ensures proper medical attention. It also helps
everyone to get an accurate account of what happened and helps
your employer address safety concerns if there are any.
2. Work
together with your HEMIC claim representative, your employer
and your medical providers.
HEMIC believes
your recovery is enhanced by your involvement in your care,
and your commitment to getting better. We encourage communication
with your claim representative to discuss the benefits available
to you and the overall claim process. Open communication helps
you understand what is going on so you can feel comfortable
with the process.
3. Maintain
contact with your employer.
Your employer
is genuinely interested in your recovery and will recognize
your loyalty and commitment to the company if you stay in touch
throughout your recovery. Regular updates will also help your
company meet their scheduling needs. These efforts help foster
a positive environment when you return to the job.
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Claims
Documents
- download
the WC-1 (282 kb PDF)
Instructions
(284 kb PDF)
(EMPLOYER’S REPORT OF INDUSTRIAL INJURY)
- download
the WC-14 (481 kb
PDF)
(EMPLOYEE'S WAGE REPORT FOR FIFTY-TWO WEEKS PRIOR
TO DATE OF INJURY)
- download
the Employer Return to Work Offer Letter (25 kb DOC)
(Work Transition Program Duties within Worker’s
Abilities and Limitations)
- download
the Job Analysis
Form (25 kb XLS)
(Job Analysis Spreadsheet)
-
download
the Time Sheet
(42 kb DOC)
(Weekly Time Sheet)
-
-
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For more
information on reporting accidents and filing claims, see our
Claims page.