Filing/Reporting


When and where do we file (report) a claim?

File the Employers’ First Report of Injury as soon as you hear about the injury.
•    Early reporting is the key element to positive claim outcomes.
•    Once an injury or illness has been reported, the employer should report to WCF as soon as possible.
•    Report a claim online here. You can also file a claim by calling (800) 561-8008 or faxing (801) 351-8275.

What information is helpful to include in our report?

Complete all required fields on the first report of injury. Give as much detail as possible regarding the accident.
•    Social Security number
•    State hired
•    Job title
•    Witness names and phone numbers
•    If the employee will lose time from work
•    Document any disputes of the injury in the “Doubt Validity” area on the initial report of injury and explain in the comment section
•    Even if you doubt the validity of the claim, you should report the claim
•    Reporting an alleged injury or illness is not an admission of liability

What if a third party is responsible for the accident?

File the claim as soon as you are aware of the accident.
•    List all information regarding the third party
•    The claim will be referred to the subrogation department for possible recovery
•    If the injury is related to a motor vehicle accident and the claim is accepted, workers' compensation coverage is primary over auto coverage.


Benefits
 

Are medical benefits covered for our employee?

Medical expenses that are reasonable and necessary to treat a work-related injury or illness are covered if a claim is accepted. This also includes reimbursement for the cost of mileage to and from medical treatment.

Will our employee be compensated for lost wages due to the injury?

When a worker is injured, each missed day of work represents lost wages. Indemnity benefits are paid to the employee to help them cover their loss of income. Payments are a portion of the workers’ average weekly wage and take into consideration the extent of disability. 


Return to Work
 

When can our employee return to work after an injury?

An employee can return to work after a treating doctor releases the employee to modified duty or full duty work. If you can accommodate suitable light-duty work, the employee is required to accept the work or risk losing their lost time benefits. 

Why should we accommodate work restrictions?

It facilitates successful return to work once the employee is returned to full duty.
•    Helps manage claims costs
•    Lowers chances of litigation
•    Can reduce possible fraud

How do we offer modified duty?
Develop a modified duty return to work program in writing.
•    This should include a start date, temporary duties, work restrictions, and the next review date
•    You and the injured worker agree to follow the plan
•    The injured worker should know who to report problems to
•    All participants should sign the plan
•    If you cannot accommodate light duty, contact you adjuster to discuss options with our vocational rehabilitation counselors 


Other Resources
 

How do we access claim information on the employer portal?

Sign in to the policyholder portal here.
•    Hover over Claims
•    Click on Track a claim
•    Enter claim number

How can we get help with our OSHA 300 log?

You can contact our Safety Department at (385) 351-8103 or use our Ask a Safety Consultant feature.
 

Does WCF Insurance have a preferred provider?

Access preferred providers by state here.

What resources are available for Spanish speaking employers and employees? 

Spanish speaking adjusters along with Spanish interpreters are available to help with interrupting and translation issues for claims. Contact the Spanish line at (385) 351-8511.

What if the employee files a legal action?

We will provide legal representation on your behalf.

What do we do if our employee brings us a bill from their doctor related to a claim?

Send the bill to the adjuster and the adjuster will contact the provider to get the billing information corrected.

If you have additional questions but the claim has not been assigned to an adjuster, contact our management team.

For Utah claims:
Linda Collins: lcollins@wcf.com, (385) 351-8128    
Kristie Suchar:ksuchar@wcf.com, (385) 351-8926

For all other states:
Stacey Gowen: sgowen@wcf.com, (916) 888-1707