Worker’s Compensation Teleclaim Questions
This information is valid for employees located in West Virginia ONLY.
Employees located in the following states who need to file a workers’ compensation claim should refer to the accompanying information:
North Dakota Washington
Ohio Wyoming
Puerto Rico
Employees in all other states who need to file a workers’ compensation claim should refer to the Hartford TeleClaim information.
If an OCA employee has an accident while at work, the employee should notify his or her supervisor IMMEDIATELY. It is the supervisor’s responsibility to contact the West Virginia Workers’ Compensation Division and report the employee’s injury by the end of the day. IF THE EMPLOYEE IS IN A LIFE-THREATENING SITUATION AND IS IN NEED OF IMMEDIATE CARE, HE OR SHE SHOULD BE TRANSPORTED TO AN EMERGENCY MEDICAL CENTER RIGHT AWAY. In this instance, the supervisor is permitted to report the injury after the employee has received medical attention.
BrickStreet First Reports
304-926-3470 or 1-866-45BRICK
Supervisors should be prepared to answer the following questions. The more information you have available to you when you call, the less time the call will take, and less time will be needed for follow-up. Phone reports last approximately ten minutes.
Employer Information
Company Name: Orthodontic Centers of West Virginia. You MUST specify that the employer is Orthodontic Centers of West Virginia
Policy Number: WC10034145-03
Injured Worker Information
Name
Address
Social Security Number
Age
Sex
Marital Status
Number of dependents
Date of hire
Length of time in current job position
Wage information
Injury
When the injury occurred
Where the injury occurred
How the injury occurred
Type of injury (cut, burn, etc.)
Exact part of body injured
Names of witnesses
Name and address of physician or hospital
Anticipated return to work date
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