Employee Report of Injury Procedure

Fill out the First Report of Injury Form (attached above). 

Write, in the upper right hand corner of the form, which Workers Comp code applies to the claim and send to the Human Resource Representative. 

 

The Codes Are:

         

                    Middletown & Florence:  1449536

         

                    Norwood:  1490399

         

                    Fairfield:  1490532

Send employee for immediate medical treatment

Employee may go to any medical treatment facility

Employee should tell the treatment facility that they work for ASDStaffing

The medical facility may contact the Human Resource Representative at 513-939-1900

Get a note stating when employee can return to work. Are there any limitations?

Bring in all paperwork to the HR Rep. or the Fairfield office

The employee should provide their own transportation to the treatment facility. If they do not have a ride, they need to call for one, take a cab (we will reimburse for the cost with a receipt) or call an ambulance

The employee will need to bring in all paperwork given to them by the treatment facility and all receipts for medications so that they can be reimbursed

Make sure we have the employee’s proper address and phone number in the system so we may contact them if need be

Before returning to work, the employee must provide a release to return to work from their medical provider