The following forms may be used to report an illness or injury for workers’ compensation.
Use the checklists below for help with the workers' compensation process. For questions regarding the process, contact the VCU Human Resources Workers’ Compensation office at firstname.lastname@example.org or (804) 828-1533.
Initiating a claim
While your claim is open:
IMPORTANT: Injuries that result in hospitalization, amputation, loss of eyesight, or death must be reported immediately to Safety and Risk Management.
Helping an employee initiate a claim
Investigating the accident
While the claim is open
Workers’ compensation claims management:
VCU Workers’ Compensation Office, 804.828.1533 or email@example.com.
Claim determination, medical authorizations, billing:
Managed Care Innovations (MCI), 804.649.2288.
Medical issues, work restrictions:
Panel physician or Employee Health Services, 804.828.0584.
Department timekeeper or VCU Human Resources Leave Administration, 804.828.1712.