How to Report an Injury and File a Workers' Compensation Claim
- Should you become injured on the job, seek immediate medical attention (first aid or visit a medical provider), if necessary.
- Request an accident report form (ARFIE-SI) from your supervisor or Human Resources Department or download it from the website.
- Complete pages 1, 2, and the first half of page 3 of the ARFIE-SI. Make sure to indicate if you sought or plan to seek medical treatment on the top of page 2.
- Forward the completed form to your direct supervisor for completion of the form's final section.
- Supervisor shall then fax the completed forms to (614) 525-5715 or email the completed form to Risk Management: Jerry Bower - email@example.com
or Jenell Williams - firstname.lastname@example.org
- Supervisor shall place a follow up phone call to 614-525-4642 to alert Risk Management of a new claim filing. Please provide the following information:
- The supervisor's name and phone number
- Employing agency
- Name of injured person
- Brief description of employee's injury
- The back pages of the County's Injury Packet lists local BWC certified physicians and treatment locations. To locate a complete listing of all workers' compensation certified physician, log on to www.ohiobwc.com.
Note: In cases of severe injury that incapacitate an employee(s), the supervisor shall perform steps 2 through 5 and provide as much information known to the supervisor at this time.