Page | 10 If it is after hours and you cannot reach the NSU Workers’ Compensation Manager or Adjuster, to tell you where to go for treatment and your PCP is not available, go to the nearest emergency room and let the NSU Workers’ Compensation Manager and the Adjuster know as soon as possible what has happened. Per Florida Statute 440.13(2) (f), an injured worker is entitled to a one time change per accident. The insurance company will authorize an alternative physician within five days of receiving a written request from the injured worker. If medical care is provided outside an authorized approved network, the employer chooses the physician. Transportation during Disability Period: Medical transportation is available if the injured worker needs it. If the injured worker uses his/her vehicle for transportation to medical providers, they are reimbursed at the current rate of 44.5 cents per mile. The carrier/servicing agent can supply mileage forms, or the employee can retrieve same online at http://www.nova.edu/cwis/fop/risk/forms/workers_comp.pdf. Call CCMSI immediately on 407-660-5637 | 1-866‐291‐0194 or the NSU Workers’ Compensation Manager on 954-2625404 if you need transportation or cannot make an appointment. Prescription Benefit: Medications can be dispensed at any pharmacy (see myMatrixx listing). The injured worker pays no co-pay (prior to MMI) for Rx. if an authorized medical provider prescribes medical services, devices, appliances, etc., as it relates to the injury/illness. Please contact your claim adjuster at CCMSI (407-660-5637 | 1-866‐291‐0194) or the NSU Workers’ Compensation Manager (954-262-5404) for authorization prior to receiving service for assistance. Notification from Insurance Company: Within 3-5 business days after you or the NSU Workers’ Compensation Manager report the accident, you should receive an informational brochure explaining your rights and obligations, and a Notification Letter explaining the services provided by the Employee Assistance Office of the Division of Workers’ Compensation. These forms may be part of a packet which may include some or all the following: ▪ A copy of your accident report or “First Report of Injury or Illness,” which you should read to make sure it is correct. ▪ A fraud statement, which you would have already read, signed and returned to the NSU Workers’ Compensation Manager for forwarding to the insurance company. If you have not done so, then you must read, sign and return it as soon as possible, or benefits may be temporarily withheld until you do so.
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