Workers' Compensation Information

  • Workers’ Compensation Procedures

    hazard Important:
    Do not file work related injuries on your group medical or prescription plans. File only with the Workers’ Compensation Carrier.


    If you are injured while at work:

    • Report your injury to your supervisor immediately
    • See campus nurse for evaluation if possible
    • Complete injury forms and return to the Leave Specialist in a timely manner
    • Visit Network Physician as necessary
    • Search for Network Urgent Care Locations
    • Notify supervisor, Leave Specialist and benefits department of work status

    Forms to be completed:

    Complete and Return to the Leave Specialist

    • Employee Acknowledgment of Workers’ Compensation Network form
    • Employee Choice to Use Paid Leave form
    • Accident Investigation Form

    Employee Keeps

    • Workers' Compensation Temporary Income Benefits and your Waller ISD Pay document
    • Workers’ Compensation Information document
    • Workers' Compensation Verification of Coverage document
    • WorkWell, TX Network Clinics/Physicians near Waller document

     

  •  
    Leave Specialist
    Mirthea Alicia Martinez
    Phone: 936-372-4064
    Fax: 936-931-0396
     
    Office Hours
    Monday: 7 a.m. - 3:30 p.m.
    Tuesday - Thursday: 8 a.m. - 4:30 p.m.
    Friday: 7 a.m. - 3:00 p.m.

    Workers’ Compensation Carrier
     
    Texas Mutual
    1-800-859-5995
    Pharmacy Info: Optum
    Pharmacy Phone:
    1-888-220-2805