Procedure for Reporting a Work-Related Injury
If you are injured at work, you are responsible to notify your employer immediately. If your supervisor is not available, you should notify Human Resources. Your supervisor will then need to complete the First Report of Injury Form with you present. Your supervisor will hand the form into Human Resources.
It is required that you treat with the Panel Health Care Providers for the first ninety (90) days of treatment, from the date of the first visit to a designated provider.
Unauthorized, non-emergency treatment during the first ninety (90) days with a Non-Panel Health Care Provider will not be paid by your employer or their carrier.
If you choose to treat outside of the list of Panel Health Care Providers after the first ninety (90) days, your employer must be notified within five (5) days of treatment with the Non-Panel Health Care Provider.
In case of emergency, you may seek treatment at the closest Emergency Room. In such case, you or an immediate family member must notify your supervisor or Human Resources immediately. Remember, it is important to tell your employer about your injury. Any questions may be referred to:
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF LABOR AND INDUSTRY
BUREAU OF WORKERS' COMPENSATION
HARRISBURG, PA 17104-2501
Send bills to:
Shared Services Claims Department
c/o Shared Services Consortium, LLC
P. O. Box 90
Mechanicsburg, PA 17055-0090
Phone: 800-641-6330 or 717-796-1459
Fax: 800-706-9344 or 717-796-1916