D 100 Staff SOPs (Knowledge Base)

    How to Make a Workman's Comp Claim SOP

    Updated 2/21/25
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      Steps to File a Claim

      Call 1-855-921-9518

      (please add as a contact in your cell phone)


      Or go online at CompanyNurse.com to click on the bottom right corner   


      This is an incident report and begins the Workmans’ Comp process. You will receive a text from Sedgewick, our insurance carrier, within 24 hours, please provide your cell phone for contact.

      In the event of an injury that renders you uncomfortable to drive yourself for care, please call a loved one to pick you up or call 911 for an ambulance.  Do not drive yourself if you feel it is unsafe.  

      You, as the employee, are in control of where you choose to seek treatment and will inform the Company Nurse.  It is in your best interest to go to an Urgent Care, Walk-In Clinic or Emergency Room where an appointment is not required to be seen immediately.  

      For additional information please use the FAQ section to assist with your possible Workman's Compensation question. 

      The District 100 Wellness Center is not a primary clinic for Workmans’ Compensation injuries.  The clinic does not have x-ray services available, please do not call for this type of treatment. 

      Common Treatment Care Locations:

      OrthoIllinois Riverside - Injury Express 815-398-9491  5875 East Riverside, Rockford, IL 61114  OPEN - 8:00 AM - 8:00 PM  For Broken Bones, X Rays and Treatment by an Orthopedic Physician


      Physician Immediate Care (or any location) 815-544-0040 1663 Belvidere Rd, Belvidere, IL 61008  OPEN - 8:00 AM - 8:00 PM  For Immediate Treatment including X Rays 


      UW Health Belvidere Hospital (or any ER) 815-544-0040 1625 South State St, Belvidere, IL 61008  OPEN 24/7  For any Emergent Treatment including X Rays 

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      Workers Compensation Insurance Compensation Election Form

      Please review the options in this form for payment during your time off work due to workers compensation. Select an option for election. Choose only ONE option. This form will notify District 100 Benefit Coordinator, Monce Medina in the HR Office.

      Please note that the options given are not the District's policies but it is pursuant to the Illinois Workers Compensation Law which only allows for the Temporary total Disability benefit to be two-thirds (66 ⅔%) of the employees average weekly wage, subject to minimum and maximum limits.
    If you still have a question, we’re here to help. Contact us