Valley View School District 365U Worker’s Compensation
Our Worker’s Comp Carrier… Just an FYI… Valley View’s worker’s comp is self funded. This means that Valley View is responsible for the payments made for all worker’s comp claims. Gallagher Bassett Services, Inc. is our Third Party Administrator. They are responsible for processing the claims.
Why you should report an injury… When a claim is reported, the following happens: The injury is documented with the District. 1. Valley View becomes aware of a potential 2. dangerous situation. It could help prevent a similar injury from 3. reoccurring. Failure to report an injury could delay benefits, or 4. coverage under worker’s comp.
Who to report an injury to… Employees should report all injuries immediately that occurred at work to protect themselves. At a school, employees should report an injury to their building designee (principal, nurse or supervisor). Other District employees (district maintenance, transportation or print shop) should report an injury to their immediate supervisor.
Forms that need to be completed… WC forms to be completed by WC forms to be completed by employee designee (Principal, Nurse, Supervisor) Authorization for Release of Employers First Report of Injury Information or Illness (Form 45) Employee Report of Injury Supervisor/Witness Report Please send all completed forms to Brandy McCurrie in Human Resources ASAP.
Where to access these forms… All worker’s comp forms are available through the designee at your building. You can also access the forms on the District’s website at www.vvsd.org under the Human Resources Department.
Medical Facilities… Below are medical facilities in the area affiliated with worker’s comp injuries. Physician’s Immediate Care Edward Corporate Health 130 N. Weber Road, Suite 108 391 S. Bolingbrook Drive Bolingbrook, IL 60440 Bolingbrook, IL 60440 (630) 646-5770 (630) 226-1006 (1/4 mile south of Boughton Rd) (Route 53 North of I-55/South of Lily Cache) Weekdays: 8:00 a.m. – 11:00 p.m. Weekdays: 7:30 a.m. – 11:00 p.m. Weekends & Holidays: 8:00 a.m. – 5:00 p.m. Weekends: 7:30 a.m. – 4:00 p.m. Premier Occupational Health 550 E. Boughton Rd, #140 Bolingbrook, IL 60440 (630) 972-0733 (East of Route 53) Weekdays: 7:00 a.m. – 7:00 p.m. (Non-Doctor Visits) Weekdays: 10:00 a.m. – 6:00 p.m. (Doctor Visits) Saturday: 9:00 a.m. – 2:00 p.m. Sunday: Closed Please Note: These facilities are strictly optional. Emergency rooms are only used in the case of a life threatening injury.
Additional Medical Services… Additional medical services (i.e., doctor’s appointments, x -rays, tests, physical therapy, surgery, etc.) needs to be pre-approved by Gallagher Bassett Services, Inc. prior to scheduling Employees in need of additional medical services, should contact Donna Tincher at Gallagher Bassett Services, Inc. at (847) 273-0374 or by email donna_tincher@gbtpa.com
Medical Bills/Medical Reports… The medical provider should forward all medical bills and accompanying medical reports to: Gallagher Bassett Services, Inc. P.O. Box 2831 Clinton, IA 52733-2831 (800) 370-0594 All other correspondence should be sent directly to the adjuster: Donna Tincher, WC Claim Representative E-Mail: donna_tincher@gbtpa.com Phone #: (847) 273-0374 Fax #: (847) 240-6660
Who you should contact if you have questions/concerns… Please contact Brandy McCurrie in Human Resources with any questions or concerns regarding worker’s comp. Brandy can be reached at the Administration Center on extension 6054.
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