​​​​​​​​​​​​​​​​​​​​​​​​​​​​​

Upon notification of a work-related inju​ry, the supervisor is required to complete a Supervisor's Report of Injury form. Any delay in reporting may require additional investigation and cause an unnecessary delay in authorizing treatment or processing benefits. If medical treatment is required, the injured worker must complete ​the Industrial Packet provided by his/her department and report to the contracted occupational medical provider for initial treatment and work status. 


 

For life threatening emergencies, dial 911 and/or report to the nearest hospital emergency room.​​


 

EVERY INJURY AND/OR ILLNESS MUST BE REPORTED IMMEDIATELY TO THE SUPERVISOR.


 

ILPA EXAMPLES HERE!​

 

Adjuster Information ​

York Risk Ser​​vices:

Main Office: (480) 606-5575

F​ax: (480) 606-5598

*Please have your Name a​nd Date of Injury available to be transferred to the adjuster assigned to your claim.

Forms