Notice to Employees

  • The name, address and telephone number of your employe's Workers' Compensation Insurance Company is:

    New Jersey Manufacturers Insurance Company (NJM)

    301 Sullivan Way

    West Trenton, NJ 08628-0118

    Phone: 609-883-1300

    Expiration date of policy: July 1, 2020

Forms & Managed Care Search

Reporting a Claim

  • In the Event of a Work-related Injury:
    1. REPORT THE INJURY TO YOUR SUPERVISOR & TO HUMAN RESOURCES PROMPTLY! You do NOT need to report your injury to a school nurse. 
    2. Sign and submit the INJURY REPORT FORM and NOTIFICATION OF RIGHTS & DUTIES FORM to Human Resources as soon as possible. 
    3. If you need to seek medical attention, OBTAIN MEDICAL CARE FROM A DESIGNATED MANAGED CARE PHYSICIAN.
      You must treat with a managed care professional for a period of ninety (90) days. Except in extreme emergency, if you go to a non-panel provider, the bills may not be covered by Workers' Compensation. If a panel provider refers you to another physician, bills will be covered.
    4. If your injury is minor and you do not need to seek medical attention, or you wish to wait to see if medical attention is required, the District has up to 120 days to file a claim on your behalf. In this case, complete the Injury Report Form and Notification of Rights and Duties form and forward to Michele Zimmerman or Carlie Cole. The District will NOT file a claim with our carrier until/unless you decide to seek medical attention. 
    * If the injury is deemed to be a medical emergency and emergency care is required, call 911 and request an ambulance for transport. Otherwise, an emergency contact should be called to transport the employee to an urgent care center for evaluation. Please contact a member of HR for contact information if you do not have it.
     
    Recording Absences
    • For the first 7 calendar days - absences following your initial physician evaluation should be recorded as sick time using the applicable absence code/method available to you.
    • Beginning with the 8th calendar day - record absences using the available workmans compensation code in our absence management system(s). In most cases accrued sick time is deducted. 

    Prescription Services
    • Once your workers' compensation claim is established, an information letter and prescription card will be mailed to you at your home address. If you have not received a card within two days after your claim is reported, please contact your NJM Claims Representative
    • Visit JNM's Pharmacy Benefit page for more information
     
    Declining Medical Treatment After A Workplace Injury
    • Under the Pennsylvania Workers' Compensation Act, you have 120 days to file a claim until you can no longer receive workers' compensation benefits.
    • If your injury is minor and you decline to seek medical treatment after a workplace injury, complete the Injury Report Form and Notification of Rights and Duties Form and return to Human Resources within 24 hours of the incident. Your report form will be kept on file in the event that you need to seek medical treatment and file a claim. Forms may be emailed or faxed to Michele Zimmerman at 610-562-2634.
     
    Fraud Notice
     
    In Pennsylvania, any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact materials thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties.