- Claims Process
Reporting the Accident
If you have an on-the-job accident, you should immediately notify your supervisor. You should tell your supervisor exactly what happened, how it happened, who saw what happened and whether you were injured as a result of the accident. If you are a witness to a work related accident where a fellow employee is injured severely enough that the involved employee cannot notify his supervisor, you should attempt to notify the supervisor for him. This may be as simple as calling the supervisor to report that an accident has occurred.
As soon as possible after an accident occurs, you or your supervisor should call the Workers' Compensation Call Center at 866-245-8588 (toll-free) and complete an accident form via telephone. Information obtained by the Call Center enables the claims adjuster to determine whether your injury is compensable under the workers' compensation law. A copy of the accident information completed by the Call Center will be sent to your human resource office. You may also report the accident by going to https://sedgwickcms.claimcapture.com. You must obtain your agency's sign-on information from your human resource office to log onto this secure site. If all the information requested is not provided, no decision can be made. This will result in a delay in payment of your medical/pharmacy bills and temporary total disability benefits. Generally, you will be notified as to whether your injury is compensable within 90 days of the date your claim information is received by Sedgwick.
Before seeking medical treatment you should complete and print a first fill form. The first fill form can be accessed by selecting the first fill tab from the menu at the top of this page or to the left of this page under "related topics." This form should be presented along with your prescription to the network pharmacy of your choice. A network pharmacy can be found HERE. The network includes: CVS, Kroger, Publix, Rite-Aid, Target, WalMart and Walgreens as well as most independent pharmacies.
The first fill form can be used on a one-time basis at a network pharmacy of your choice with no out-of-pocket expense. The first fill form entitles you to a 10-day supply of medication. Upon acceptance of the claim, Cypress Care will mail a pharmacy card which is to be presented each time you fill a prescription.
For most injuries use of the first fill form allows for a 10-day supply of medicine with a limit of $150 per prescription.
For injuries involving blood borne exposures you are allowed a 14-day supply of a prophylactic medicine with a limit of $1,000 per prescription.
Seeking Medical Treatment
If you have an on-the-job accident which requires medical treatment, you must choose a provider who is authorized in the state's workers' compensation network. This will be the only physician authorized to treat you for your compensable injury. This means that the state will only accept and pay medical expenses submitted by this physician, unless your treating physician notifies Sedgwick that you have been referred to another network physician for treatment. The state will not pay any medical expenses you incur from a physician other than your treating physician or a network physician you are referred to by your treating physician.
When seeking medical treatment, you should notify the doctor's office that you were injured while at work and that you will be filing a claim for workers' compensation benefits with the state.
In summary, if you have an accident at work
Contact your supervisor to report your injury.
You can report an accident by calling 866-245-8588 (toll free) or by going to https://sedgwickcms.claimcapture.com. You must obtain your agency's sign-on information from your personnel officer to log onto this secure site.
If you need medical treatment, call the State's Administrator, Sedgwick, at 1-800-526-2305, or Rockport Healthcare at 1-800-734-4460, for the name of a provider who is authorized to treat you. Or, choose a physician from the list of authorized providers. The provider directory can be accessed by selecting the Provider Directory from the menu at the top of this page. The list is also available from your personnel officer.
- Complete and print the first fill form. Present it to the network pharmacy of your choice along with your prescription. The first fill form can be accessed by selecting the first fill form tab from the menu at the top of this page or to the left of this page under "related topics."