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Worker Injury

The safety and health of every employee is a high priority. Employees are expected to take responsibility for performing work in accordance with safe standards and practices. Safety and health are achieved through teamwork. We all must work together in promoting safety, health and taking reasonable measures to ensure safe working conditions exist.

UTSA’s Workers' Compensation Insurance is specifically designed to provide medical benefits, and in some cases, financial payments, if you suffer a work-related injury or occupational illness. For an injury or illness to be work related, it has to originate while you are engaged in the work your job requires you to do for the university. All employees whose names appear on the payroll of the university are covered under the program at no personal expense. This coverage includes student and wage employees.

Reporting an Injury

It is important to report an injury as soon as possible after seeking appropriate medical attention. Follow the below instructions for reporting an injury that occurs in the workplace. For more information, call (210) 458-8178.

  1. Notify your supervisor immediately, no matter how minor the injury may seem. If necessary, report unsafe working conditions to your supervisor or to us at (210) 458-5250.
  2. If necessary, obtain medical attention. If it is an emergency, seek care from the nearest urgent care facility or hospital emergency room. Inform the medical provider that your injury is work related. Your department will provide you with a Notification of On-The-Job-Injury form (English | Spanish) to give to your medical provider.
  3. Complete and sign the Network Acknowledgement form using your physical home address (No P.O. Box). Work with your employer to determine if you live in a network covered service area. You will find a list of covered counties using the IMO link and instructions below.
    • Select a treating physician from the network if you live in a covered service area:
      Go to www.injurymanagement.com and search for a provider or call IMO at 877-870-0638.

    *If you do not live in the network service area but choose to opt in to the network you may do so by signing the Out-of-Network Participation letter stating that you agree to participate in the network. You may obtain this letter from your employer or claims adjuster. Please note that once you voluntarily agree to participate in the network, you must remain in the network for any future compensable injuries.

  4. If you miss work due to an on the job injury, you must keep your supervisor informed of your work status by providing a Division of Workers’ Compensation Work Status Report (DWC-73) after each doctor visit. The doctor’s office must provide this report to the injured employee.
  5. You must also complete the form Workers’ Compensation Leave of Absence (WCI 23) to select the type of leave you wish to use. The form is provided by your department.
  6. When your doctor releases you to return to work, you must report to work at the beginning of your next regularly scheduled shift. The DWC-73 report from your doctor indicating a return to work date or any work-related limitations must be given to your supervisor before you may return.
  7. Employees should tell pharmacies about WCI and provide them with the phone number of the UT System/RXBridge prescription network (1-833-792-7434) if there are any problems. They should also have their DWC-73 Texas Worker’s Compensation Work Status Report and the Provider Notification of an On-The-Job-Injury form in hand when they go to the pharmacy.
  8. For more information, contact the Worker’s Compensation Office in the Office of Risk & Emergence Management at (210) 458-8178 or the UT System/CCMSI Claims Adjuster at (888) 802-0692.

*Continue medical treatment with a network provider, unless prior approval from the Network is granted.

*Remember, if you receive care from an out-of-network provider you may be financially responsible for the health care services if it is determined that you live in the network service area.

*If you are dissatisfied with the network you may file a complaint by completing Complaint Form #IMO MSN-3. To obtain and submit this form contact IMO by calling (877) 870-0638 or emailing them at netcomplaint@injurymanagement.com

For more information you may visit The University of Texas System health care network home page at: https://www.utsystem.edu/offices/risk-management/workers-compensation-insurance-0

  1. If the injury is an emergency, arrange for appropriate medical treatment. The employee has the right to select his or her own treating physician. Keep in mind that some physicians do not accept Workers’ Compensation insurance, so refer the employee to a  Provider Network. If employee is incoherent, the supervisor or administrative staff may select an emergency facility. Send a responsible employee to accompany the injured employee.
  2. If the injury is not an emergency, complete the  Notification of On-The-Job Injury form (English  |  Spanish), for the employee to give to his/her medical provider.
  3. All work-related injuries or illnesses must be reported. Have the employee complete the  Employer’s First Report of Injury or Illness form and the Network Acknowledgement form, and the supervisor complete the Supervisor’s Report of Injury or Illness form. Fax it to the Workers' Compensation office at (210) 458-7450 within 24 hours from the time of the injury. Once the form has been faxed, send the original form through campus mail to the Workers' Compensation office. This form is required whether or not there is lost time from work.
  4. If the injury/illness involves more than one day of lost time from work, fax a copy of the Employer’s First Report of Injury or Illness form to the Workers' Compensation office at (210) 458-7450, then send the original through campus mail. Additionally, the employee and department representative must complete the Workers’ Compensation (WCI 23) Leave of Absence form. The form is necessary for each period of time the employee has lost time (more than a day/shift due to the injury). Finally, the employee must be given notice that he or she will be placed under the  Family Medical Leave Act (FMLA) from the first day of absence if the employee and injury are eligible under the law. Call the People Excellence office at (210) 458-4250 for more information about FMLA and procedures to follow.
  5. Forward all doctor's bills and/or notes to the Workers' Compensation office immediately upon receipt.
  6. The unsafe condition that caused the injury should be corrected. If assistance is necessary to accomplish the correction, call us at (210) 458-5250.
  7. If you have any questions, contact the UT System Claims Analyst at (888) 802-0692.

Preauthorization

Q: What is the main number for Pre-Authorization?
A: 214-217-5939 or 888-466-6381

What is the fax number for Pre-Authorization?
A: 214-217-5937 or 877-946-6638

Q: Is there a Preauthorization Request Form available for Providers?
A: You can call the pre-authorization number listed above to request a Preauthorization Request Form.

Bill Review

Q: If I need to reach someone in the bill audit section via telephone, what number do I call?
A: You can call the bill auditing department by dialing 888-802-0692. Their fax number is 972-386-7918.