Workers' Compensation

Encova Insurance is our managed care organization and will help you with all of your Worker's Compensation needs. Please download the Worker Compensation Injury packet below, as it will help guide you if you get hurt at work.

Related Files:

What should you do if you are injured on the job?

If you have a medical emergency, please seek medical attention at the nearest medical facility. Immediately notify Nicole Heydt, Benefits Coordinator at Ext. 3918 and your direct supervisor. Obtain a Workers' Compensation Injury Packet to complete. They are located at main offices and nurses offices, or downloaded from the links above.

Your benefits could be delayed or denied if you do not notify your employer immediately.

ALL injuries MUST be reported within 24 hours.

What is contained in the Workers' Compensation Injury Packet?

  • Employee Statement of Injury or Illness and Supervisor Accident Investigation Report

    • Completed by the employee immediately (for claim purposes) and supervisor returned directly to Nicole Heydt at the District Office located at the High School Room 328.

  • Medical Records Release

    • Reviewed, signed, and dated by the employee and returned to Nicole Heydt at the District Office.

  • Worker's Compensation Information-Employee's Rights & Duties under Section 306

    • Reviewed, signed, and dated by the employee and returned to Nicole Heydt at the District Office.

  • Notice: Medical Treatment for Your Work Injury or Occupational Illness Form

    • Reviewed, signed, and dated by the employee and returned to Nicole Heydt at the District Office.

  • Jim Thorpe Area School District Workers Compensation Doctor Panel

    • Keep for your records

  • Physician Statement of Physical Capabilities

    For Medical Claims.

    • Reviewed by employee and taken along to doctor appointments. Have a doctor complete form and return to Nicole Heydt at the District Office.

  • Optum First Fill Prescription Card

    • This allows a prescription to be filled for the first time related to your workers compensation injury. It is accepted at CVS, Rite Aid, Wegmans and many other pharmacy chains.

Be sure to complete all forms in the packet and have your supervisor sign accordingly.

If you have questions regarding a Worker's Compensation matter, please contact Nicole Heydt, Benefits Coordinator at 570-732-3918 or by e-mail.

 

REPORT A CLAIM AS SOON AS IT HAPPENS NO MATTER HOW SEVERE THE INJURY