4 NSU Florida Guidelines (Section A) _________________________________ Employer Responsibilities during a Non-Emergency 1. Contact Novalert at 954-262-8999 about the accident/injury. 2. Complete all pages of the injury document to include the First Report of Injury Form (DWC1), NSU Employee Statement Regarding Cause of Accident, CCMSI Authorization for Medical Records and Communication Release, and CCMSI False and Fraudulent Claim Warning. Forms may be downloaded at https://www.nova.edu/risk/forms/workers-comp.pdf. 3. Provide the injured worker with a copy of the fully executed forms (Case # will be provided once injury is reported to CCMSI). 4. Instruct the employee that he or she has the right to medical care. Assist the employee seeking care with calling HPD (Employee Health clinic) to ensure availability at 954-2621860, 954-262-2183, or 954-262-4100. If HPD cannot schedule with the employee or is closed, the individual should be sent to UrgentMed or Concentra based on their location. Other PCP offices must be approved by the Office of Risk Management. 5. Email all executed forms including the First Report of Injury Form, NSU Employee Statement Regarding Cause of Accident, CCMSI Authorization for Medical Records and Communication Release, and CCMSI False and Fraudulent Claim Warning to the Office of Risk Management to bcharmai@nova.edu. If Dr. Beckford is on vacation, please send to risk@nova.edu | workerscomp@nova.edu. Steps for an Emergency 1. Contact Novalert at 954-262-8999 immediately. Novalert will contact 911 when needed. 2. Proceed by following steps 2 thru 5 above.
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