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The University of Tennessee Space Institute

UTSI Human Resources

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Workers' Compensation

If you are an employee of the University of Tennessee Space Institute, and have an accidental injury while you are working at your job, then you may be covered by the Workers' Compensation Program of the State of Tennessee. Please contact the HR office at ext. 37504 if you have any questions or need assistance.

*How to file a claim - if medical treatment required
*How to file an "incident only" report - if medical treatment not required

Click here to see Workers' Compensation Changes effective July 1, 2016.

Click here for a wallet card to place in your wallet/purse for easy access to Call Center information.

Click here for a Flow Chart reflecting steps to follow.


TO FILE A CLAIM - if medical treatment required

Steps to follow: 

  1. REPORT the accident/injury to your supervisor immediately
  2. You and your supervisor shall call the Workplace Injury & First Notice of Loss (FNOL) Call Center at 1-866-245-8588, option #1, immediately after the occurrence of the incident.  The injured employee will speak with a 24/7 registered nurse to evaluate the nature of the injury and determine immediate care or treatment options.  If medical treatment is recommended, the nurse will direct the employee to the nearest State-approved medical provider. The State will not pay any medical expenses you incur from a physician not in the network.  Call 911 for Medical Emergencies.
  3. To complete the reporting process your supervisor can ask the registered nurse to transfer the call to the First Notice of Loss (FNOL) Unit, or directly call 1-866-245-8588 and select option #2.  If you prefer, the Human Resources personnel can call and complete this process once they receive the "Report of On-The-Job Injury or Illness" from the employee/supervisor.
  4. EMPLOYEE AND SUPERVISOR MUST COMPLETE AND SIGN the "Report of On-The-Job Injury or Illness" immediately and return it to the UTSI Human Resources office.
  5. Employee must read the Workers' Compensation Instructions/Procedures handout and sign the cover sheet stating they have received and read this document.  This is required by the State Division of Claims.

FORMS TO COMPLETE: (return to UTSI HR asap)
1. "Report of On-The-Job Injury or Illness"
2. Workers' Compensation Instructions/Procedures document (employee must sign cover sheet)
3. Initial Medical Information Checklist

PRESCRIPTIONS: If the injured employee might need a prescription, please stop by the HR office for a "First Fill" form to take to a participating pharmacy.  This form allows the employee to fill initial prescriptions with certain limits with no cost to them.

For additional information on the new workers compensation process, click here.

In turn, HR submits a copy to the UTSI Safety Office so they may address any safety concerns and/or reporting requirements.  If you need assistance completing the forms, please contact the Human Resources Office at ext. 37504.

See the UT Human Resources Policy No. 397, Workers Compensation, for more information regarding time off from work, etc.

UTSI Human Resources Office 1-931-393-7226
CorVel (24/7 Triage nurse OR report a new FNOL)1-866-245-8588
CorVel (claims adjuster) 1-888-226-7835
Division of Risk Management & Claims Administration 615-741-2734

For additional information, see weblinks below:
UT Human Resources Policy No. 397, Workers Compensation
State of Tennessee Workers Compensation website
UT Risk Management Office
UT Risk Management Forms


TO FILE AN "INCIDENT ONLY" REPORT - if medical treatment NOT required

Steps to follow:

  1. REPORT the accident/injury to your supervisor immediately.
  2. You and your supervisor shall call the Workplace Injury & First Notice of Loss (FNOL) Call Center at 1-866-245-8588, option #1, immediately after the occurrence of the incident.  The injured employee will speak with a 24/7 registered nurse to evaluate the nature of the injury and determine immediate care or treatment options.  State to the nurse that it is a REPORT ONLY - NOT SEEKING MEDICAL TREATMENT.
  3. EMPLOYEE AND SUPERVISOR MUST COMPLETE AND SIGN the "Report of On-The-Job Injury or Illness" immediately and return it to the UTSI Human Resources office. Employee must read the Workers' Compensation Instructions/Procedures handout and sign the cover sheet stating they have received and read this document in the event that the injury progresses to the point of needing medical care. 

FORMS TO COMPLETE: (return to UTSI HR asap)
1. REPORT ONLY - NOT SEEKING MEDICAL TREATMENT
2. Workers' Compensation Instructions/Procedures document (employee must sign cover sheet)


The University strongly encourages anyone who has a minor incident that does not require medical treatment to file an "incident only" report.
Supervisors should submit an "incident-only" report for a work-related injury or illness, which does not involve medical attention or time lost from work, or for which an employee refuses to file a claim.  If the minor incident develops into something more significant, there will be a record on file. Please contact the FNOL call center and return the required forms to the UTSI Human Resources Office as stated above. In turn, HR submits a copy to the UTSI Safety Office so they may address any safety concerns and/or reporting requirements.

Please contact the HR office at ext. 37504 if you have any questions or need assistance.

Rev. 05/23/2016

Contact Us

By mail:
Human Resources,
    Equity & Diversity
Univ. of TN Space Institute
411 B.H. Goethert Parkway
Tullahoma, TN 37388

Ph: (931) 393-7226
Toll Free 1-888-822-8874
ext. 37226
Fax: (931) 393-7268
Email

Staff Contacts

Patricia Burks-Jelks,
Human Resources Director,
Equity & Diversity Officer
(931) 393-7226

Pam Ledford, Benefits
(931) 393-7504

Courtney Maricle-Frazier, Payroll
Ph: (931) 393-7267

More Staff Information

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