Texas W/C Claim Kit s2

WC CLAIM KIT – Florida

Who will handle your claims? The Orlando Claim Office will handle your Florida claims, located at:

1064 Greenwood Blvd., Ste 300 P O Box 958426 Lake Mary, FL 32746 Lake Mary, FL 32795-8426

Phone: 407-710-4900 Phone: 800-423-3060

How to report Workers’ Compensation claims?

To report via the Internet: Log on to the Crum & Forster website at http://one.cfins.com. Use your assigned User ID and Password. If you do not have a current User ID, please contact your local Crum&Forster Claims or Marketing resource.

To report via fax: 1-877-622-6218 To report claims via telephone: 1-800-690-5520 (7 day/24 hour toll free reporting line for all states)

 In the event of a serious or fatal injury, notify the local claim office immediately by telephone.

What are the Reporting Requirements? What forms does the employer need to be aware of?

Florida Form: DFS-F2-DWC-1 First Report of Injury or Illness: If you report the claim via the Internet or by telephone, this form does not need to be completed. If you report the claim via Fax, complete the form, and Fax it to C&F at the Fax number provided above.

"Fl-First Report of Injury.pdf"

Florida Brochure: DFS-F2-DWC-65 Employer Facts / IMPORTANT WORKERS’ COMPENSATION INFORMATION FOR FLORIDA’S EMPLOYERS This brochure will give you a better understanding of your role and responsibilities under the workers’ compensation system.

"Fl- WC Info for Fl Employers.pdf"

Florida Form: DFS-F2-DWC-1a Wage Statement

"Fl-Wage Statement.pdf"

What is the Waiting Period for Lost Wages in Florida? The waiting period for lost wages in Florida is 7 days. If the injured worker is off for more than 21 days, the first 7 days are paid retroactively.

What are the Choice of Physician Rules In Florida? The Carrier has the right to select the physicians.

Preferred Provider Organization Network (PPO): Crum & Forster has a PPO network available. Follow the instructions below to access the PPO Network:

Logon to the website at: http://www.corvel.com

 Select the “PPO Lookup” box under “Connect”  Select the “Search” button under “Find a Provider”  Using the drop down option, select “Workers’ Compensation” in the “Select a Network” box  Fill in or select from the drop down options for the remaining fields. Make sure you limit your search by selecting the provider type for specialty or service  When you have completed all the files, select “find providers that meet the search criteria” to obtain a list of providers meeting your search criteria

Important Websites Click on this link for the official website for the Florida Division of Workers’ Compensation: http://www.fldfs.com/wc/

Multi-State Information: http://www.workerscompensation.com/