After Filing an OJI Claim

What you need to know after you file a claim and go to the doctor.

  • It is the employee’s responsibility to notify their supervisor of the status of their work injury, if the physician has released them to work with restrictions, what those restrictions are, if the physician states they are out of work, and the dates.
  • Most restrictions can be accommodated with light or restricted duty or a temporary job assignment. It is up to the employer, not the employee, to determine if accommodation can be met.
  • Employees should not use their health insurance plan or present their insurance card for treatment or for prescriptions.
  • Contact the Insurance and Risk Management Department for a First Fill Card to present to an authorized pharmacy. 
  • If the physician returns you to work on light or restricted duty the supervisor will determine if accommodation can be met. The supervisor will complete the Employee Accommodation Plan or sign off on the return-to-work note provided by the physician and submit to [email protected]. If you refuse the accommodation, it will disqualify you from out of work benefits (TTD) through the OJI Program.
  • If the accommodation cannot be met you may qualify for out of work benefits (TTD) through the OJI Program. 
  • The date of injury will be paid as a normal working shift.
  • If accommodation cannot be met or the physician puts you out of work due to the OJI the first seven (7) calendar days are considered a waiting period. Temporary total disability (TTD) benefits begin on the eighth (8th) calendar day of the disability period for days you are normally scheduled to work. Consult with your supervisor about the use of sick leave, or other available leave, for the seven-day waiting period.
  • TTD benefits are due starting the eighth (8th calendar day of the disability period. However, if the disability period reaches fourteen (14) calendar days TTD benefits will go back to the first day of the disability period and will continue until the employee is returned to work by the physician.
  • You will not receive TTD benefits for days you are not normally scheduled to work.
  • TTD benefits are based on 66.67% of your gross average weekly wage for the last 52 weeks worked prior to the injury. TTD benefits are paid weekly by check through the third-party administrator, TPA.
  • If you refuse to comply with any reasonable request for medical examination, to accept medical treatment, or any other provision of the OJI Program, all OJI benefits may be terminated.
  • If you have any questions, please contact the Safety Coordinator at 615-898-7715 or send an email to [email protected].