Work Site & Employee Guidelines

Employee Guidelines

When you have a work-related injury or illness:

  1. Immediately report your work related injury or illness to your supervisor and the Benefit Contact at your location;
  2. Complete a Notice of Injury for the Injury or Illness with supervisor and/or Benefit Contact at your location;
  3. Choose a Primary Treatment Site from the list on the Medical Authorization for Treatment form for your initial treatment;
  4. Take the Medical Authorization for Treatment form with you to the doctor.

After you receive medical care:

  1. Take a copy of the Notification of Initial Treatment and the Return to Work Recommendation to your supervisor or Benefit Contact within 24 hours (All subsequent changes of work status must also be brought to your supervisor within 24 hours.);
  2. Follow your authorized medical provider's instructions;
  3. Return to active work as soon as you are released for duty by your treating physician. Light Duty work will be provided if your doctor releases you to work with restrictions. (Please refer to Workers' Compensation Light Duty Program FAQs for more information about the Light Duty Program.);
  4. If your doctor refers you to a specialist, all referrals must be approved by a Johns' Eastern claim representative (1-800-749-3044).

Work Site Guidelines

When an employee reports an injury or illness:

  1. Submit a Notice of Injury, (NOI) form in
  2. Complete Medical Authorization for Treatment form (if medical attention is required);
  3. Give the injured employee:
    • Employee copy of the First Report of Injury or Illness
    • Workers' Compensation Employee Guidelines
    • Employee copy of Medical Authorization form (if medical attention is required)
    • Pharmacy Authorization form (if medical attention is required)
    • Light Duty Program FAQs.

After an employee receives medical care:

  1. Every time the injured employee receives medical treatment, ask for copies of the following:
    • Notification of Initial Treatment from treating doctor (initial treatment, only)
    • Return to Work Recommendation from treating doctor (all future appointments).

Maintain Employer/Worksite copies of all forms!

If you have any questions, call Johns Eastern toll-free claims assistance at 1-800-749-3044.

Workers' Compensation - Submit a Notice of Injury (NOI)