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Employee Injury

If you have been involved in an accident and need emergency medical assistance, call 911 immediately.

1. Stop and Help

If an accident has just occurred, stop and examine the situation. Make sure your surroundings are safe and seek medical attention for anyone who may be injured. If emergency assistance is needed, call 911.

2. Complete Reports

Employee Injury Report

Require the employee to complete an Employee Injury Report describing the following information.

  • Date and location of the accident.
  • Specifics of the accident which caused the injury.
  • Parts of the body which were injured.

First Report of Injury

Complete a First Report of Injury form. Send it to the workers compensation insurance claim office promptly.  Your specific claim office will be identified in the Capitol Insurance Claims Kit which was sent to your business following your last renewal.

You will also need to either send a copy to Capitol Insurance or phone your claim in to the 800 reporting claim center offered as an option by some insurance companies. If you need help with this process, call Capitol at (317) 253.1155.

Call Capitol at (317) 253.1155

3. Forward Medical Bills

Forward all medical bills to the insurance company’s adjuster. An adjuster will be assigned to you after the First Report of Injury form is submitted. If you have initial bills, you may also submit them along with the form.

4. Keep Employees Safe

Investigate the accident to identify and implement corrective action strategies to prevent similar types of  accidents in the future.