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Thank you for using our online Workers’ Compensation (Work Comp) Form. The purpose of the form is to report any injuries sustained on assignment by Teachers On Call (TOC) substitutes. The submitter of this form must be the injured party and a TOC employee.   

If you are seeking medical treatment for an injury, please call TOC at 800-713-4439 to obtain a health pass for treatment. You will be connected to an individual who will email you the necessary information for medical assistance. You can also ask to speak with an HR Associate if you are needing help completing this form or have other questions regarding work comp. Questions can also be answered by emailing us at workerscomp@teachersoncall.com.

Work-related injuries should be reported to TOC within 24 hours of the incident. By notifying TOC you ensure your claim will be processed in a timely manner.  Late claim submissions or submissions from unapproved parties can result in denial. 

If you find yourself in a medical emergency, please call 911 for immediate assistance. 

Your Name (injured TOC employee).
Date injury was reported to TOC or School (which may or may not vary from the date you are submitting form) 
teacher, paraprofessional, custodian, etc. 
Absence Management Confirmation number of your worked assignment. This confirmation number will help verify your injury occurred while you were working as a TOC substitute. 
:
Signed-in (start time) of your assignment. 
:
Signed-out (end time) of your assignment. 
Select specific date injury incident occurred (which may or may not vary from your date reported). 
:
Time incident took place 
Provide which specific building your injury took place at.  
This number can be found in your Absence Management account under your assignment details. 
Please provide specifics of what you were doing at the time of the injury (actions, events, tasks, interactions, etc).  
Presenting symptoms caused by injury. 
What do you believe caused the injury to happen? 

Please list all formal and informal treatments (cold/warm compresses, medication, etc.). 
Employees may choose to seek medical treatment for their work injury. When/if an employee determines medical treatment is needed, they are to call TOC at 800-713-4439 to obtain a health pass for treatment.  
Initial disclosure of this information is essential to ensure appropriate medical care is addressed and can help a medical provider in determining when you have returned to your pre-existing status.   
Answering the above questions will provide TOC with the information needed to submit your work comp claim. Typically, you will not need to submit an injury report to the school directly, as TOC handles all claims for TOC employees.   Additional questions, feedback and concerns pertaining to this report can be emailed to workerscomp@teachersoncall.com  or faxed to HR at 1 800-713-3299. 
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