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Worker's Compensation

Workers’ Compensation Procedures

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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

Mirthea (Alicia) Martinez
Phone: 936-372-4064
Fax: 936-931-0396 

Workers’ Compensation Carrier
 

Texas Mutual: 1-800-859-5995
Pharmacy Info: Optum
Pharmacy Phone: 1-888-220-2805

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.