WVU Extension Service

Worker Compensation

Worker Compensation Process

On-the-job injury/illness is an event not to be taken lightly by either employees or supervisors. If you experience an OTJ injury/illness, you must report it! For the most information visit the WVU HR – Workers Compensation site. Questions regarding worker compensation may be directed to the WVU HR Medical Management Unit staff at (304) 293-5700×8 or via e-mail: medicalmanagement@mail.wvu.edu. You can also go to the WVU Medical Management Forms page.

A. WVU’s Supervisor’s Workers Compensation Packet small pdf icon was updated in 2010. This PDF includes:

  • Instructions,
  • the Supervisor’s Injury/Illness Report Form,
  • the On-The-Job Injury Witness Statement Form,
  • a sample Temporary Total Disability Benefits or Sick Leave Benefits Option Election Form,
  • and the WVU Medical Verification Form.

Steps to Take for Workplace Accidents, Injuries, and Illness

1. Notify your supervisor immediately, and contact Amanda Biddle at Medical Management within 24 hours: (304) 293-HURT (4878)

2. Make sure documentation is submitted as quickly as possible. This can help you get all the benefits for which you may be entitled.

  • Be sure that your supervisor completes the injury/illness report and return it within three (3) days.
  • The original report must be mailed to Employee Health & Safety (EH&S) and a copy of the report must be faxed to Medical Management (304-293-2644).
  • If the employee is unable to complete these steps, then it is the supervisor’s responsibility.
  • These steps must be completed even if you do not seek medical treatment.

3. If you seek medical treatment, and want to file a Workers’ Compensation claim, then:
  • Be sure the treating physician accepts Workers’ Compensation insurance.
  • Notify the treating physician that you have sustained an on-the-job injury.
  • Complete the form BI-1&2 at the treating physician’s office (BrickStreet Mutual Insurance is WVU’s Workers’ Compensation Carrier)
  • You should file your claim as close to your injury date as possible.

4. A release to return to work must be provided by your physician to Medical Management before you will be able to return to work, regardless of the amount of time missed.

Mail Original Report To:

WVU Office of Environmental Health and Safety
Attn: Injury/Illness Prevention Program
PO Box 6551
Morgantown WV 26506-6551

FAX Copy of Report to:

WVU Human Resources
Medical Management Unit
PO Box 6640
Morgantown WV 26506-6640

OR

B. Employee Option to file Worker Compensation Form ( Download WC-1 Form Word doc, or WC-1 Form PDF small pdf icon . Updated September 2010

  • Six months from injury date to file

    1. If not filing, signed statement required

    2. If filing, send completed form to:

WVU Human Resources
Medical Management Unit
PO Box 6640
Morgantown WV 26506-6640

C. Witness Statement required if injury was witnessed – Available in the new Workers Compensation Form Packet small pdf icon .

D. A Release Form Word doc, or Release Form PDF small pdf icon – authorizes review of medical records related to the injury/illness. Reviewed September 2010

E. Option Election Notice – completed after consultation with Medical Management staff

F. Return to Work Notice Form small pdf iconReviewed September 2010

Helpful Links

Download a flyer small pdf icon of the basic instructions for your office.

Brick Street Insurance Website

Download Workers Compensation Form Packet PDF small pdf icon Updated September 2010

WVU Medical Management Forms page