Workers Compensation - A Division of Risk Management

AHRMS Policy

Emergencies

Filing a Workers' Compensation Claim

Forms to complete:

Form AR-N (two page form)  Employee completes Form IA-1 (two page form)  Supervisor completes Public Employee Claims Division Form  Employee completes WC Travel Expense Form - Mileage form Form H Form P

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Important Addresses and Phone Numbers

Injuries:

•  Before/After AHOC hours
•  Non-Urgent Situations
•  Urgent Situations

Job Injury Procedures

Training Programs

The University of Arkansas is committed to the health and well-being of our employees. Risk Management encourages employees to report work-place hazards and for everyone to know what to do should an injury or illness occur while on the job.

Emergencies

Dial 911 for Emergency Response.
Follow up care should be arranged with the University Health Center, or  Arkansas Occupational Health Clinic (AOHC).

Go immediately to the University Health Center, or AOHC during clinic hours, or dial UAPD at 5-2222.

Make an appointment at University Health Center, dial 575-4451.
Hours 8:00 a.m. to 6:00 p.m. M-F, or an appointment must be made by the employee’s supervisor, dial 725-3001 or 725-3003.  AOHC Clinic Hours: 7:00 a.m. to 6:00 p.m. M-F, and 9:00 a.m. to 12 noon, Saturdays.

Before/After Hours

Injuries that require immediate attention, go to Washington Regional Medical Center Emergency Room.
Follow up care should be arranged with the University Health Center, or  Arkansas Occupational Health Clinic (AOHC).

 

Job Related Injuries Addresses and Phone Numbers

If you become injured or ill while you are working at the University and you wish to file a Workers’ Compensation claim, certain forms must be filed by the University with the Public Employee Claims Division (PECD) and with the Arkansas Workers’ Compensation Commission (AWCC).

1. The forms listed below must be completed and submitted by the University within ten (10) days from the date of the injury or illness. Medical and lost time claims will not be considered until these forms are completed and submitted to the Public Employee Claims Division and to the Commission.
• Form AR-N, front and back,  Arkansas Workers’ Compensation Commission Employee’s Notice of Injury. Must be completed in ink by employee or someone on employee's behalf and submitted to your supervisor.
• Public Employee Claims Division form, dated 2/97. Must be completed in ink by employee or someone on employee's behalf  and submitted to the employee’s supervisor.
• Form IA-1, front and back, First Report of Injury or Illness Form. Must be completed in ink or typewritten and signed by your supervisor. This form must be completed by employee's supervisor.
2. Completed and signed Workers’ Compensation Commission forms must be submitted to the University Workers’ Compensation Coordinator in the Office of Risk Management as soon as possible, but no longer than three (3) days from the date of the accident.
3. The Workers’ Compensation Coordinator will ensure that the forms are properly completed and signed and will submit all relevant information to PECD as soon as possible.

If you or your department would like to schedule a training session on Workers' Compensation policies and procedures, please call 575-4195 for more information.

Topics Include:

• What to do when an employee is injured
• U of A Early Return to Work Program
• State laws concerning Workers' Compensation
• Safety tips pertinent to your particular area