Generally

Workers Compensation is an insurance plan provided by Pittsburg State University to pay certain benefits to employees who are injured on the job. All university support staff and unclassified employees, graduate assistants and student employees are covered by Workers Compensation Insurance.

The Division of Workers Compensation, Kansas Department of Labor, administers the Kansas Workers Compensation Act. The law provides that if an employee is injured or becomes sick due to work, that employee may be eligible, as determined by the State Self Insurance Fund (SSIF), to receive medical coverage and compensation for lost wages subject to a weekly maximum. Claims for Workers Compensation are processed by SSIF.

Complete information can be found on the Worker Compensation poster found on the HRS Posters and Notices page.

Visit the Worker's Compensation Claim Walkthrough for step-by-step instructions on filling out the claim form.

Additional information can be found on the Worker's Compensation one-pager.

Covered Incidents

Only injuries that have occurred out of and/or in the course of employment activities and not caused by misconduct may be compensable by the State Self Insurance Fund/Workers’ Compensation program.

If An Accident Occurs

If the injury occurs during normal business hours and is not severe:

  • An employee injured on the job should immediately notify his or her supervisor or other designated individual unless the injury prevents such notification. The department manager must assign another individual to complete these tasks if the employee’s immediate supervisor is unable to do so.

  • If physically able, the employee who is injured on the job must complete the PSU Incident Report even if he or she does not miss work or seek medical treatment. The notification must be completed within 5 calendar days from the date of the accident or repetitive trauma, or it could jeopardize compensation.

  • Obtain prior authorization for medical treatment, if necessary, by calling the 24/7 Nurse Triage Line at:

1-833-756-2007

  • The Supervisor must complete an electronic Claim Submission, via the SSIF web portal and submit it within 20 calendar days after the incident. Click the link below, choose HR/Supervisor with an Injured Employee, then SSIF Web Portal.If you need access to the SSIF Web Portal, email sehbp.wc1101a@ks.gov.


  • Refer any medical provider to the State Self Insurance Fund at 1-785-296-2364 if contacted for authorization of medical care

  • If the accident or injury occurs while at work, the above steps must be completed, and a claim must be filed with SSIF even if the employee declines treatment or does not miss work at the time of the injury or illness.

  • Please keep in mind that if the injury is not deemed to be work-related by SSIF, the employee will be responsible for any costs not covered by the employee's health insurance plan for the emergency room visit. Additionally, injuries that did not result from or occur in the course of employment activities may not be covered by workers' compensation.

If the nature of the employee's injury is serious or life threatening, or if the accident occurs outside of regular business hours,  and the employee determines medical treatment is necessary immediately, the injured employee should proceed directly to the facility noted below.  The injured employee must notify the provider that the injury was incurred on the job. 

The injured employee must provide the supervisor with any medical information related to the work injury provided by the employee's healthcare provider.  It is important that the employee keeps his or her supervisor informed if the employee will miss work or seek medical help because of a job injury.

  • As soon as the injured employee is physically able, he or she should immediately notify his or her supervisor or other designated individual. The department manager must assign another individual to complete these tasks if the employee's immediate supervisor is unable to do so.

  • If physically able, the employee who is injured on the job must complete the PSU Incident Report even if he or she does not miss work or seek medical treatment. The notification must be completed within 5 calendar days from the date of the accident or repetitive trauma, or it could jeopardize compensation.

  • Obtain prior authorization for medical treatment, if necessary, by calling the 24/7 Nurse Triage Line at:

1-833-756-2007

  • The Supervisor must complete an electronic Claim Submission, via the SSIF web portal and submit it within 20 calendar days after the incident. Click the link below, choose HR/Supervisor with an Injured Employee, then SSIF Web Portal. If you need access to the SSIF Web Portal, email sehbp.wc1101a@ks.gov.

  • Our agency number is 385.
  • Refer any medical provider to the State Self Insurance Fund at 1-785-296-2364 if contacted for authorization of medical care

  • If the accident or injury occurs while at work, the above steps must be completed, and a claim must be filed with SSIF even if the employee declines treatment or does not miss work at the time of the injury or illness.

  • Please keep in mind that if the injury is not deemed to be work-related, by SSIF, the employee will be responsible for any costs not covered by the employee's health insurance plan for the emergency room visit. Additionally, injuries that did not result from or occur in the course of employment activities may not be covered by workers' compensation.

 

Where to Seek Medical Attention:

Obtain authorization for medical treatment by calling the 24/7 Nurse Triage line at 1-833-756-2007

PSU Employees working in the Pittsburg area:

  • Minor/Non-life-threatening injuries would be seen at the medical facility authorized by the 24/7 Nurse Triage line.
  • Serious/Life-threatening injuries would be seen at the Emergency Department at Mercy Medical Center.

PSU Employees working in the Kansas City area:

  • Minor/Non-life-threatening injuries would be seen at the medical facility authorized by the 24/7 Nurse Triage line.
  • Serious/Life-threatening injuries would be seen at the Emergency Department at KU Medical Center.

 

Absences for Seeking Medical Treatment

The injured employee will be excused from work without loss of pay or accrued leave in order to obtain medical treatment on the day of the accident or injury. Additionally, the injured employee will also be excused from work without loss of pay or accrued leave to obtain further medical treatment related to the injury. The employee must, however, limit absences from work to the time required to receive medical attention only. The employee may also be required to furnish satisfactory proof of having received medical treatment. 

 

Overview of Supervisor Tasks:

If an employee is injured on the job, the employee’s supervisor must perform the following tasks depending on the severity of the injury.  The department manager must assign another individual to complete these tasks if the employee’s immediate supervisor is unable to do so.

  1. If the employee needs immediate medical attention:

    1. Assist injured employee in getting medical help.
    2. Assist the injured employee in contacting the 24/7 Nurse Triage Line at 1-833-756-2007 for authorization of medical treatment.
    3. Assist the employee in completing a PSU Incident Report. This must be completed within 5 days of the injury or illness.
    4. Complete an electronic Employers Report of Accident via the SSIF web portal and submit it within 20 days after the incident. Follow these instructions to access the portal and complete the electronic form: State Self Insurance Fund Portal 
    5. If computer access is unavailable, call State Self Insurance at 1-785-296-2364 to do a telephone First Report of Injury.
  1. If the employee does not need immediate medical attention:

    1. Within 5 days, assist the employee in completing a PSU Incident Report. This must be completed even if the employee does not seek medical treatment or misses work. 
    2. Assist the injured employee in contacting the 24/7 Nurse Triage Line at 1-833-756-2007 for authorization of medical treatment.
    3. Complete an electronic Employers Report of Accident via the SSIF web portal and submit it within 20 days after the incident. Follow these instructions to access the portal and complete the electronic form: State Self Insurance Fund Portal 
    4. If computer access is unavailable, call State Self Insurance at 1-785-296-2364 to do a telephone First Report of Injury.

 

 

To complete the Employers Report of Accident for the SSIF Portal or the First Report of Injury, the following information is required and should be completed as much as possible:

General:

  1. Date of Injury or Illness
  2. Agency Number: 385

Employee Information:

  1. Full Name
  2. Date of Birth
  3. Gender
  4. Social Security #
  5. ID #
  6. Physical Address
  7. Mailing Address
  8. Email Address
  9. Work Phone Number
  10. Mobile Phone Number 
  11. Home Phone Number

Employment Information:

  1. Date of Hire
  2. Employee Status
  3. Employment Type
  4. Hours per week
  5. Days per week
  6. Supervisor's First Name
  7. Supervisor's Last Name
  8. Supervisor's Work Phone Number
  9. Supervisor's Email Address

Accident/Injury Information:

  1. Loss of Life?
    1. Death Result of Injury?
    2. Date of Death
    3. Marital Status
    4. Number of Dependents
  2. Occurrence
    1. Time employee began work
    2. Time injury/illness occurred
    3. Date Supervisor/Employer notified
    4. Body Part (primary if multiple)
    5. Accident Premises
    6. Cause of Injury
    7. Nature of Injury
    8. Description of how injury/illness occurred
    9. Injury address
    10. Witness name (If applicable)
    11. Witness phone number
  3. Treatment
    1. Medical treatment sought?
    2. Physician Name
    3. Physician Address
    4. Hospital Name
  4. Other
    1. Form completed by
    2. Title
    3. Phone Number
    4. Email
    5. Comments

Note: Submission of the electronic Employer's Report of Accident does not mean that the employee has been approved by Workers Compensation. The SSIF will investigate the claim once it is received and will determine compensability.

Supervisors may need to contact HRS to obtain some employee data needed to complete the Employers Report of Accident.


Contacts

State Self-Insurance Fund
Mills Building, Suite 600
109 SW 9th Street
Topeka, KS 66612
(785) 296-2364
(785) 296-6995 – FAX
wc1101a@ks.gov (send additional paperwork or medical notes)

 

Workers Compensation Division
Kansas Department of Labor
401 SW Topeka Blvd, Suite 2
Topeka, Kansas  66612-1227
(785) 296-4000
(785) 296-0025 – FAX
kdol.wc@ks.gov

Page revision date: 12/04/2024

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