Adopted: July 1980
Revised: December 2021
Download 406.7.1P - Work Related Injury/Illness Reporting Process
An employee who has been injured at work or has a work-related illness should promptly report their injury/illness by completing the following steps within 24 hours of the incident/onset of illness.
1. Employee, along with their supervisor/administrator or nurse, will call State Fund Mutual (SFM) at 1-855-675-3501 to report the injury or illness.
1.1 Calls can be made 24 hours a day, and all information will be handled and maintained with utmost confidentiality. Employees who work outside of standard business hours whose supervisor/administrator is unavailable at the time of injury/illness onset may contact SFM directly to complete their report, and then inform their supervisor/administrator the following business day.
1.2 In addition to reporting the injury/illness, employees will be given the opportunity to speak to a nurse, who can help advise the employee regarding medical care.
2. During the call, employees will be asked to provide the following information:
2.1 Worker’s Compensation policy number for District 196: 76129.506
2.2 Demographic information (name, job title, address, date of birth, social security number, employee number, etc.)
2.3 Specific details on the injury/illness (date, time, location, body part(s) affected, how injury/illness occurred, witness name(s), etc.)
2.4 Any medical treatment already sought and/or the need to seek medical treatment
3. As the call concludes, SFM will provide the employee with their claim number. This number can be provided, along with the other information on the card depicted below to the employee’s care provider if they have sought/will seek medical treatment related to their injury/illness.
4. Any work restrictions and/or lost time from work should be communicated to the supervisor/administrator and Human Resources right away. Human Resources can be reached by calling 651-423-7700 or emailing HRinfo@district196.org.
5. Questions should be directed to Human Resources by calling 651-423-7700 or emailing HRinfo@district196.org.