Human Resources Department

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Workers' Compensation

North Allegheny School District has provided for the payment of benefits under the Workers' Compensation Act of Pennsylvania with:

            Insurance Company:        Old Republic Insurance Company in care of:

                                                                  School Claims Service, LLC
                                                                  Workers' Compensation Division
                                                                  P.O. Box 813
                                                                  New Cumberland, PA   17070

                                                                  Insurance Contact:   Workers' Compensation Claims Department

                                                                  PHONE:  866-402-6600        FAX:   866-402-6601
 


North Allegheny Workers' Compensation Coordinator:   
Diane Napolitan, Benefits Manager
 

     REMEMBER  --  IT'S IMPORTANT TO TELL YOUR EMPLOYER ABOUT YOUR INJURY   

    It is imperative that you obtain the Workers' Compensation Work-Related       
    Incident Report
form from the Secretary in your Building or Department, complete the form immediately and return it to the Secretary. 

Be sure to advise the Secretary if the incident resulted from an encounter with a student.  

   In life-threatening situations, immediately seek medical assistance, then complete      
   the Workers' Compensation Work-Related Incident Report.   

bulletIf you suffer a work-related injury, your employer or its insurance company must pay for
reasonable
surgical and medical services and supplies, orthopedic appliances and
prostheses, including training in their use.
 
bulletATTENTION:  Custodial/Maintenance employees, Bus Drivers, and Mechanics

      
 --    In order to ensure that your medical treatment will be paid for by your employer
              or the insurance company, you must select from the physicians or other
              health care providers designated on the Panel Physician List posted in your work
              areas.

        --    You must obtain treatment from one of the providers listed, if you need treatment,
               for 90 days from the date of your
               first visit.

        --    All reasonable medical supplies and/or treatment related to the injury will be
              paid by the employer provided treatment is obtained from a designated provider
              during the 90 day period.

        --    Changing health care providers during the 90 day period is acceptable providing
               you stay within the selected panel of providers.  When a designated panel
               provider refers outside the panel, the employer will pay for treatment rendered
               this referral provider.  Emergency treatment may be obtained form ANY provider. 
               However, subsequent, non-emergency treatment will be provided by a designated
               panel provider for the remainder of the 90 day period. 

        --    Obtaining treatment or medical consultation from a non-designated provider shall
               be at the employee's expense for the applicable 90 days.  After the 90 day period,
               treatment may be obtained from any health care provider of choice.  If treatment
               is found reasonable and necessary, the employer will pay for incurred expenses
               that are in direct association to the original work related incident.

     
   --    You are required to notify your employer of treatment by a non-designated provider
               within five (5) days of the first visit to that provider.  The employer may not be
               required to pay incurred expenses to the non-designated provider prior to
               receiving such notification.  The employer will pay for services once notified,
               unless treatment is found to be unreasonable by a URO, under Subchapter C.
 
bullet All other employees (Administrators, Confidentials, Paraprofessionals,
Professionals) may obtain treatment from any health care provider of choice. 
(It may be to the employee's benefit to choose a provider from their health
insurance network in case a work related claim is denied.)
 
bulletNOTE:  If you are being treated by a physician and given a prescription to be filled,
DO NOT use your Health Assurance card at the pharmacy to pay the regular
copay.  Since the prescription is for a work-related injury, charges should not go
to Health Assurance.

Pay for the prescription in cash or charge it on a credit card and turn in the receipt
and description of the drug purchased to Human Resources to be reimbursed.
You can also ask your pharmacist if the purchase of the drug can be handled by
them and the cost sent to School Claims Service.

 
       CONTACTS:
                    School Claims Service                866-402-6600
                    NA Benefits Manager:                  412-369-5546

             Send Email to Benefits Manager

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©2003 North Allegheny School District, Central Administration Office

 200 Hillvue Lane, Pittsburgh, PA  15237
Tele: 412-366-2100