Report an Injury

We’ve got your back… in the event of an injury follow these guidelines.

In case of life and/or limb threatening injury dial 911 immediately. Then, as soon as possible contact Risk Management at 800-301-1992 for further instructions.

In the event that an occupational injury or illness occurs, please complete the steps listed below. If it is not an emergency the employee must be referred to the nearest Occupational/Industrial clinic.

Step 1: Report the Incident to Extreme Reach Payroll Solutions & complete the necessary W/C Forms

Immediately contact Risk Management and notify them of the injury or illness. The online Medical Treatment Authorization Form must be completed by the injured employee’s supervisor and sent with the employee to the medical treatment facility. You will then need to complete the appropriate Worker’s Compensation Injury Instructions and Forms and forward them to the Risk Management contact. Should an injury occur after hours, on a weekend or holiday, please call 800-301-1992. Should you need additional information and/or copies of the injury reports please email the Risk Management department.

In order to avoid penalties and/or fines, these forms must be fully completed and forwarded to Extreme Reach Payroll Solutions within 24 hours of your knowledge of the injury or illness. Extreme Reach Payroll Solutions recognizes that in the initial hours after the injury occurs, you may not have all of the information required. We ask that you complete the report to the best of your ability within the 24-hour time frame and call at a later time with any missing information.

Step 2: Medical Treatment

Make sure the employee receives immediate and appropriate medical attention.

The Extreme Reach Payroll Solutions Medical Treatment Authorization Form should be completed and provided to the employee prior to arriving at the Occupational/Industrial medical facility.

Serious injuries:

Any death or serious injury must be reported within two hours of the occurrence. Serious injuries include amputation, in-patient hospitalization, permanent disfigurement and injuries involving multiple employees.

Step 3: Keep Extreme Reach Payroll Solutions Informed!

Extreme Reach Payroll Solutions should be notified of all changes with regards to the injured employee’s work status including any and all wages paid on the date of the injury.