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 benefits
    • Visit Network Physician as necessary
    • Notify supervisor and benefits department of work status

    Forms to be completed:

    Complete and Return to Benefits

    • 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


    Employee Benefits Administrator 
    Becky Jimenez
    Phone: 936-372-4037
    Fax: 936-310-6584

    Workers’ Compensation Carrier
    Texas Mutual
    Pharmacy Info: Optum
    Pharmacy Phone: