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  Workers' Compensation Information  
 


Workers’ Compensation Procedures

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:

Workers' Compensation Forms Packet

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
  • Texas Star Network Clinics/Physicians near Waller document
 
     
  Contact Information  
 
 
Employee Benefits Administrator
 
Becky Jimenez
Phone: 936-372-4037
Fax: 936-931-4080

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