Guidelines

Guidelines for Employees and Supervisors

You will need these documents in order to seek medical treatment for a work-related illness or injury:

Any individual filing misleading or incomplete information knowingly and with intent to defraud is in violation of Section 1102 of the PA Workers' Compensation Act and may be subject to criminal and civil penalties through PA Act 165.

How to Report a Work Injury

  • Report work related injury/illness immediately to a supervisor or designated department contact.

  • Seek treatment with a Workers Compensation Panel Provider. When medical help is of an urgent or life-threatening nature, go to the nearest hospital emergency room and schedule a follow-up appointment with a Panel Provider when you are released.

  • If applicable, fill your prescription at the pharmacy of your choice. Show the pharmacist your activated temporary prescription card to avoid an out-of-pocket expense.

  • Within 24 hours, complete the Employee Accident Report and have your supervisor/dept. designee call in or fax it to UPMC Work Partners. You will be contacted by your assigned claims adjuster within a few days.

Allegheny County workers' compensation claims are managed by a third-party claims administrator:

UPMC Work Partners(PDF, 126KB)
Claims Management Services
Phone: 855-396-8762
Fax: 412-667-7111

Guidelines for Supervisors

Encourage employees to report all injuries, no matter how small.

If the employee needs medical treatment:

  1. Activate a temporary prescription card and give it to the employee along with a Panel Provider listing.

  2. Arrange for the employee to seek treatment with a Panel Provider, who is equipped to treat work-related injuries such as strains, sprains, cuts, broken bones, needle sticks, etc. If urgent emergency treatment is needed direct the employee to the nearest hospital emergency room.

Print out the Employee Injury Packet. Have the employee complete Section 1 of the Employee Accident Report, the Rights and Responsibilities, and the Authorization for Release of Records and Reports.

Call 855-396-8762 within 24 hours to report the occurrence to UPMC Work Partners. The line is staffed 24 hours a day, 7 days a week. This step generates a claim number for the incident.

At a later time, complete Section 2 of the Employee Accident Report. If the injury results in medical treatment and/or lost time also complete Sections 3 and 4, and conduct an accident investigation. Record the name(s) and contact information of witnesses.

Forward the completed Employee Injury Packet to your department's designee, if applicable.

Guidelines for Department Designee

Familiarize yourself with procedures for reporting a work injury and activating a temporary prescription card (see Guidelines for Supervisors section above). Review the Employee Accident Report for legibility and completeness.

Report the injury to UPMC Work Partners(PDF, 126KB):

Phone the report in to 855-396-8762 or
Fax the report to 412-667-7111

A claim number is generated immediately when you call in a claim. There will be a delay in receiving a claim number when the Employee Accident Report is faxed. Contact your department's UPMC Work Partners adjuster if you do not receive a claim number within 48 hours.

Send a copy of the Employee Accident Report to:

County Safety Officer
Facilities Management
542 Forbes Avenue, Room 107
Pittsburgh PA 15219
or Fax: 412-350-5888

Note: Billing inquiries from employees, doctors, and other medical providers should be forwarded to UPMC Work Partners(PDF, 126KB). Common causes of billing errors include an unreported claim, or incomplete/illegible report.

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