Workers Compensation

A safe working environment is our number one priority. Should an employee become injured or ill arising out of employment or during the course of employment, we want our employees to receive quality medical treatment. The following steps are to be followed when reporting a work related injury or illness.

If an employee is in need of immediate/urgent medical treatment, call 911 and immediately notify the District Office.

Step 1 - Nurse Triage

The injured employee contacts Company Nurse at (888) 770-0929. Company Nurse will triage the injury over the phone and refer the injured employee to an appropriate level of care.

Step 2 - Level of Care

If the injured employee is referred for medical treatment by Company Nurse, they can visit one of our clinics or a previously designated medical provider.

Step 3 - Forms & Paperwork

If an employee is referred for medical treatment, the following is provided to the injured employee: DWC-1 claim form, WellComp MPN, & Mitchell First Fill.

Forms

• Workers' Comp Procedures (Word)
• Claim Checklist for actual claims only (PDF)
• Company Nurse Contact Information (PDF)
• DWC-1 Workers' Compensation Claim Form (PDF)
• Accomodations Leaflet (PDF)
• Wellcomp MPN Written Notification - English (PDF)
• Wellcomp MPN Written Notification - Spanish  (PDF)
• Mitchell Temp Prescription Card - English/Spanish(PDF)