Workers' Compensation
Within 24 hours of submitting a workers’ compensation claim, employees have to give a verbal statement to both the claims adjuster and the triage nurse (Amerysis) to complete the process.
**For a life-threatening emergency, seek immediate medical treatment**
For assistance during a life-threatening emergency, please dial 404-413-3333 (on campus) or 911 (off campus).
On-the-Job Injury Reporting Procedures:
- The injured employee must notify their supervisor or HRO immediately!
- Treatment for non-life-threatening injuries can be sought at Peachtree Occupational Medicine or Concentra. Detailed information on the treatment facilities can be found under “Treatment Locations”.
- The injured employee’s supervisor or HRO must report the incident to the Office of Insurance and Risk Management (IRM) within 24 hours.
- IRM should not receive the first notice of injury report from the injured employee.
- If the injured employee has not sought treatment or does not plan to seek treatment, IRM will record the incident as “Record Only”.
- IRM will report injuries to the Georgia Department of Administrative Services (DOAS) for further processing. Once received, IRM will provide the injured employee, the employee’s supervisor, and HRO with the Workers’ Compensation Claim #.
- Exception: If an employee is involved in an auto accident, they must call Net Claims and Net Claims will collect injury information in addition to auto damage information.
Worker’s Comp Reporting Procedure
Required Documentation:
Supervisor or HRO
- GSU Modified WC-1
- Georgia Activity Analysis – send back with the employee for follow-up appts. if applicable
Injured Employee
Witness (if applicable)
The employee is required to submit a work status form from the treating physician to their supervisor and the Office of Insurance & Risk Management following each medical visit.
Please only use the forms provided on the Office of Insurance and Risk Management website. Completed forms must be submitted to Insurance and Risk Management at: [email protected].
Workers’ Compensation Forms:
- To be completed by the injured employee’s supervisor:
- To be completed by the injured employee:
- To be completed by anybody who may have seen the incident occur:
- To be provided to injured Employee when seeking medical treatment
Additional Information:
- Workers’ Compensation Employee Bill of Rights Poster – English | Spanish
- Workers’ Compensation Posted Panel of Physicians – MCO
- Georgia Department of Administrative Services FAQs
Treatment Locations
Please seek appropriate treatment according to the severity of the injury.
EMERGENCY: Dial 911
Peachtree Occupational Medicine has 24/7 coverage with two Locations.
Midtown:
1000 Northside Drive, Suite 1400
Atlanta, GA
Phone: 404-350-4717
Fax: 404-425-1214
Airport:
1901 Phoenix Boulevard, Suite 205
College Park, GA 30349
Phone: 404-425-1212
Fax: 404-425-1214
Peachtree Occupational Medicine Brochure
Peachtree Occupational Medicine Authorization Form
Immediate Medical Treatment can be obtained from the following locations:
- Caduceus USA
145 North Ave NE
Atlanta, GA 30308
Phone: 404-607-7677
Hours: Open 24/7Additional Caduceus locations can be found in and around the City of Atlanta by searching here. - Concentra Midtown
688 Spring St NW
Atlanta, GA 30308
Phone: 404-881-1155
Hours: Mon-Fri 7:30am-7pmAdditional Concentra locations can be found in and around the City of Atlanta by searching here. - Piedmont WellStreet Urgent Care
2292 Peachtree Rd NW
Atlanta, GA 30309
Phone: 404-996-0120
Hours: Mon-Fri 9am-9pm, Sat-Sun 8am-8pmAdditional Piedmont WellStreet Urgent Care Locations can be found here. - After-hours care should be sought in the nearest hospital’s emergency department
Non-Urgent Medical Care can be obtained following normal injury reporting procedures and working with the University System of Georgia’s Managed Care Organization to arrange for in-network medical care.
First Aid Only Injuries: Apply necessary first aid and report injuries to IRM as “record only”
Our Staff
Frederick Bibbs
Director, Insurance & Risk Management
Tel: 404-413-9548
[email protected]
Lajanda Casey
Insurance & Risk Coordinator
Tel: 404-413-9546
[email protected]
Vacant
Administrative Specialist, Administrative
Tel: 404-413-9545
Crystal White
Occupational Health and Safety Officer
Tel: 404-413-9547
[email protected]
Office Location
Citizens Trust Building
75 Piedmont Avenue
Suite 506
Atlanta GA 30302
Emergency Numbers
Emergencies: 911
Campus Police: 404-413-3333
Mailing Address
Georgia State University
Department of Insurance & Risk Management
P.O. Box 3961
Atlanta GA 30302-3961