On-the-Job Injury Reporting Procedures:

All employees who are injured or become ill, either physically or mentally, as a result of their job duties must report the incident to the employer immediately by completing the following instructions:

1. IMMEDIATELY  report injury to Supervisor or Human Resources Action Coordinator (HRAC) Representative who must report all on-the-job injuries to the Office of Insurance & Risk Management (SRM) within 24 hours. An employee may not call in their own injury. Seek medical attention if necessary.
   
2. Seek medical treatment as needed and according to severity of the injury: Immediate Medical Treatment can be obtained from the following locations:- Concentra Midtown – 688 Spring St NW, Atlanta, GA, 404-881-1155 is open M-F 7:30am-7pm, Sat. 10am-4pm  (Closed Dec. 25th& Jan. 1st)
   – Non-Urgent Medical Care can be obtained following steps 3-7 below.
   – First Aid Only Injuries: Apply necessary first aid and report injuries to Insurance & Risk Management as “Record Only”
   (After-hours care should be sought at the nearest hospital’s emergency department)
3. Supervisor or HRAC Representative must obtain the following forms:
   – First Report of Injury Form (Modified WC-1 to be completed by Supervisor/HRAC representative)
   – Employee Leave Election Forms (completed by injured employee)
   – Acceptance / Declination of Medical Treatment Form (completed by injured employee)
   – Employee Accident Statement Form (completed by injured employee)
   – Witness Accident Statement form (if a witness is available)Forms available here.
4. Completed forms must be submitted by email to the Office of Insurance and Risk Management to the attention of:
   Geraine Marshall
   Occupational Health and Safety Officer
   gmarshall@gsu.edu
   Phone: 404-413-9547
5. The Office of Insurance & Risk Management will contact the injured employee, the employee’s supervisor, and HR to provide them with the Workers’ Compensation Claim #.
6. Upon receipt of the Workers’ Compensation claim number, employee must call the Workers’ Compensation Managed Care organization (AMERISYS, 800-900-1582, option 2) to arrange in-network medical care.
7. Employee is required to submit a work status form from the treating physician to the Supervisor and the Office of Insurance & Risk Management following each medical visit.

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