How to Report a Work Related Injury or Illness
*NOTE: If this is a serious injury call 911 and have employee taken to the nearest Emergency Room for treatment. Supervisor should notify the Workers Compensation Office at (305) 292-4507 or 292-4448 immediately.
· Fill Out First Report of Injury or Illness (Form DFS-F2-DWC-1)
· Fax Immediately to Workers Compensation Office at (305) 295-4301 so that treatment can be authorized and arranged for the employee.
*SEND ORIGINAL FIRST REPORT OF INJURY OR ILLNESS WITH THE EMPLOYEE INFORMATION AND EMPLOYER INFORMATION COMPLETED AND SIGNED TO THE WORKERS’ COMPENSATION OFFICE, COURIER STOP #1, GATO BUILDING.
· Copy of First Report of Injury or Illness to be given to employee.
· If employee needs prescriptions filled do not use WHI (prescription card through group health plan). Show copy of First Report of Injury or Illness and advise pharmacy that this is a work related injury or illness.
· The Workers Compensation Office will inform supervisors of the employee’s work status and coordinate light duty assignments if needed.
*ATTENTION SUPERVISORS – The Florida Division of Workers Compensation requires all First Report of Injury or Illness (Form DFS-F2-DWC-1) be submitted to the department within 7 days of injury. Please make sure that the completed First Report of Injury or Illness is sent to the Workers’ Compensation Office with 24 hours of reported injury. (Due to the importance of the information provided on the First Report of Injury or Illness we ask that this form be completed by the employee and their supervisor to ensure accuracy).
Accident/Incident Investigation Report
· A completed Accident/Incident Investigation Report is also required on all First Report of Injury or Illness reported.
· Make sure that all parties have completed their section and send completed form to the Workers Compensation Office.
· All Accident/Incident Investigation Reports are reviewed by the Monroe County Safety Administrator and discussed at the Safety Accident Review Board Meetings.
*NOTE: All forms are available on the County’s website at (www.monroecounty-fl.gov) and on Microsoft Outlook (click Public Folders; click All Public Folders; click County Form; finally, click Workers Compensation).
PLEASE CONTACT THE WORKERS COMPENSATION OFFICE SHOULD YOU HAVE ANY QUESTIONS OR REQUIRE ASSISTANCE. WE CAN BE REACHED BY PHONE AT (305) 292-4507 OR 292-4450. OUR OFFICE IS LOCATED AT 1100 SIMONTON STREET, ROOM 2-268, KEY WEST, FL 33040, COURIER STOP #1, GATO BUILDING.
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