- are an employee of The University of Tennessee, and
- have an accidental injury while you are working at your job,
you may be covered by the Workers' Compensation Program of the State of Tennessee.
TO FILE A CLAIM so that your medical bills may be paid, you must follow these steps:
- REPORT the accident/injury to your supervisor immediately.
- SEEK NECESSARY TREATMENT from an authorized medical provider, such as Martin Medical Center or Kenneth Carr, MD. (If the injury is life-threatening or no other facility is available, go to the Volunteer Community Hospital Emergency Room.) You may also call the UTM Workers' Comp office or Sedgwick Claims Management Services for directions to an authorized doctor
- OBTAIN A FIRST FILL FORM from your supervisor, HR, or by printing one from the website. If the medical provider prescribes any medication as result of the injury, present the First Fill form to the pharmacist, so that you will not be responsible for paying for your prescriptions when you have them filled the first time. If additional prescriptions or refills are required, you will receive a card from Cypress Care, the pharmacy provider for Workers’ Compensation.
- COMPLETE AND SIGN the State of Tennessee "Accident Report Form" immediately or as soon as medically possible and return it to your supervisor.
- INFORM the medical provider that you are being treated for an ON-THE-JOB injury and request the medical provider to submit all bills to:
Sedgwick CMS, Knoxville Office
PO BOX 14484
Lexington, KY 40512-4484
UTM Workers' Comp Office
112 Administration Building
The University of Tennessee at Martin
Martin, TN 38238
All bills MUST include the claim number and indicate that the document is for the "Knoxville Office". The claim number can be obtained from Lisa Kinkade at (731) 881-7850.
YOUR SUPERVISOR will also sign the State "Accident Report", complete a separate "Supervisor's Report" and "Initial Medical Information Checklist" and send them to the UTM Workers' Comp office.
The UTM Workers' Comp office will file your claim for you, and you will be assigned a claims representative by Sedgwick CMS. Your claims rep will be in contact with you to answer questions, pay bills, and help you return SAFELY to work.
If you have any questions, call Lisa Kinkade in the Office of Human Resources at (731) 881-7850.
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