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Purpose

Outlines the procedures for employees seeking to complete an incident report for workers' compensation.

Procedures

  1. Employees are to report all workplace incidents to their supervisor or Human Resources immediately after the occurrence and prior to seeking treatment (if possible).
  2. Employees are to complete the Employee Report of Injury Form and supervisors to complete the Supervisor Report of Injury Form within 24 hours of incident. In emergency situations, we understand this may not be possible. (The Employee Report of Injury Form needs to be filled out and sent to the Human Resources department, even if the employee chooses not to seek medical attention)
  3. Employees must be treated at a My Michigan Health Urgent Care or McLaren Central Occupational Clinic within 24 hours of the incident. Employees are to go to the nearest Hospital Emergency Room in emergency situations.
  4. Employees who need to seek medical treatment will also need to complete the “Employee Information” section of the Authorization to Treat Form and take this form with you to the My Michigan Urgent Care Clinic or McLaren Central Occupational Clinic.
  5. Ask the Urgent Care, McLaren Central Occupational Clinic or Hospital Emergency Department to complete the second page of the Authorization to Treat form. The medical facility can fax the form to Human Resources (989-317-4631) or the employee is responsible for making sure this form gets back to Human Resources within 48 hours, along with the Work Status/Restriction Update Form that is provided by the physician.
  6. Human Resources will work with Cannon Cochran Management Services Inc. (CCMSI) and the employee’s supervisor to determine whether or not any restrictions can be accommodated. In cases where an accommodation cannot occur, employees will not be allowed to return to work until they are able to return to full duty.
  7. Employees who need further appointments or follow-up medical care must contact Human Resources to secure prior approval from CCMSI.
  8. My Michigan Health Urgent Care or McLaren Central Occupational Clinic facilities are to be used for the initial treatment, unless it is an emergency. Employees who choose to see their own physician or medical office for the initial treatment will not be covered under our worker’s compensation program.
  9. The forms needed for completing an Incident Report or obtaining the Authorization to Treat an Injury are located on the Human Resources website under HR Forms.

 

MEDICAL CLINICS 

McLaren Central Occupational Clinic: 
Mt. Pleasant – (989) 773-2339 

My Michigan Health Urgent Care: 
Alma – (989) 466-3332 
Clare – (989) 386-9911 
Freeland – (989) 695-4999 
Gladwin – (989) 246-9430 
Midland – (989) 633-1350 

 

[Last Reviewed JULY, 2024]