Workers' Compensation STEPS

MedCall - available 24/7 - (888) 735-0036

• If the team member is severely injured or having a serious medical issue, call 911. Examples include heart attack, stroke, unconsciousness, major head injury, heavy bleeding, or trouble breathing. Note what happened so a First Report of Injury can be filled out (located below --> JotForm Links).

• If the injury is not severe or you are unsure if medical treatment is needed, call MedCall from any phone with the injured team member. Examples include minor cuts, small burns, and minor slips or trips. While on the call, provide necessary details, such as employee information and incident specifics. Be as detailed as possible. Follow instructions from the MedCall provider for next steps. If you call MedCall you do not need to fill out a FROI, as they will do all of this for you!

MANAGERS - CLICK HERE FOR STEPS FOR TREATMENT (IF NOT USING MEDCALL)

First Report of Injury (FROI) - JotForm Links

• • IN First Report of Injury

  • IN First Report of Injury - Cafe 251

  • IN First Report of Injury - Commission Row

  • KY First Report of Injury

  • OH First Report of Injury

Workers' Comp Policy Flyers

• • WC Policy Flyer - CRG (IN & KY)

  • WC Policy Flyer - Cafe 251

  • WC Policy Flyer - Commission Row

  • WC Policy Flyer - OH

MedCall Flyers

• • MedCall Poster - English

  • MedCall Poster - Spanish

Indiana Locations

• • Indiana (CRG) First Report of Injury (PDF)

  • Indiana (JELM) First Report of Injury (PDF)

  • Indiana (Commission Row) First Report of Injury (PDF) 

  • Worker's Compensation - Treatment Locations (Indiana) 

  • Concentra Locations and Map 

  • Concentra Transportation Service and FAQs 

Kentucky Locations

• • Kentucky First Report of Injury (PDF) 

  • Worker's Compensation Treatment Locations (Kentucky) 

Ohio Locations

• • What to do if a Team Member is Injured

  • Ohio First Report of Injury (PDF)

  • Worker's Compensation Treatment Location (Ohio) 

Authorization for Treatment Forms

• • Concentra Authorization for Treatment Form 

  • ROCC Authorization for Treatment Form - BRU Lafayette Authorization Form 

  • Parkview Occupational Health - Marquee & BRU Ft. Wayne Authorization Form

  • IU Health Urgent Care - BRU Bloomington Authorization Form 

Miscellaneous Worker's Comp. Information

• Team Member's Declination of Worker's Compensation Treatment Form 

• Worker's Compensation Carrier Contact/Agency Contact