Workers' Compensation

Your will need to notify your administrator or supervisor within 24 hours of occurrence and complete a First Report of Injury Form. If medical attention is needed, a claim will be filed with Texas Association of School Board Risk Management Fund (TASB) to handle all aspects of our workers compensation claims including eligibility, coverage and lost time.

You must choose a primary care physician from within The Alliance provider network. Unless your personal PCP is a participating member, any treatment provided by their office will not be covered by Workers’ Compensation and your group medical insurance does not cover treatment for Workers’ Compensation injuries. The website giving a full listing of all participating providers is www.pswca.org.

TASB is a member of the Political Subdivision Workers’ Compensation Alliance (the Alliance), a network of medical providers who provide care to injured Wylie ISD employees. Employees seeking treatment under Workers’ Compensation must see a provider who is a member of the Alliance. For the full directory, please visit www.pswca.org.

Within the first 60 days of beginning treatment, if you become dissatisfied with your first choice of a treating doctor, you can select an alternate treating doctor from the list of Alliance treating doctors in your service area. TASB will not deny a choice of an alternate treating doctor. However, before you can change treating doctors a second time, you must obtain permission from your adjuster.

The primary care provider you see for your Workers’ Compensation injury will advise you if you need to see a specialist as well as handle the referral. The referral is sent to TASB pre-authorization department and can take up to seven days. If the referral is approved, the specialist office will contact the employee directly to schedule the appointment.

Under Texas Labor Code §§408.101 - 408.105, you may become eligible for temporary income benefits if a work-related injury causes you to lose all or some of your wages for more than seven (7) days. Therefore, no benefits can be paid during the first seven (7) days of disability. Your TASB adjuster can help you determine the date you may become eligible for these benefits. During the seven day waiting period the employee can elect to use local/state days or days will be unpaid which will result in dock days.

The First Fill Program authorizes an initial seven days of prescription medicine to be filled at no expense for an injured employee without delay while claims are being reported and assigned to a TASB adjuster. Once a claim is established, a prescription card will be mailed to the employee if needed. The First Fill Card is accepted at most area pharmacies. You can call 1-866-599-5426 or visit the Optum Tmesys website at www.workcompauto.optum.com for a full list of network pharmacies.

Medical bills can be sent to an employee’s residence in error. If you receive any bill related to your Workers’ Compensation claim, please send them via email to LaToya.Scott@wylieisd.net or interoffice Attn: LaToya Scott ESC. The bill will be submitted to the assigned TASB adjuster for review.

If you miss work due to injury doctor appointments, you will need to make up your time (with supervisor approval), use your available leave, or take leave without pay. The only exception is on the date of injury. We recommend that you schedule your appointments before or after work or on the weekends. If you miss any time from work due to a doctor appointment, please contact Risk Management and your assigned TASB adjuster.

A DWC-73 is a Texas Workers’ Compensation Work Status Report that is given to an employee a treating physician. Before leaving the doctor’s office, ensure that you have receive a copy of DWC-73. Ensure you completely understand what you can and cannot do both at home and work. It is the injured employee's responsibility to submit the DWC-73 to their administrator/supervisor and Risk Management after each appointment.

An Ombudsman is a specially trained employee of the Office of Injured Employee Counsel (OIEC) who can assist you if you have a dispute with your employer's Workers’ Compensation insurance carrier. This service is provided by the State of Texas and is free of charge. For more information on Ombudsman assistance please visit the Texas Department of Insurance website or call 1.800.252.7031 Monday thru Friday 8am-5pm CST.