All injured workers must contact their supervisor/employer immediately to notify them of any on-the-job injury. Claims reported after 30 days could be denied.

Your supervisor, Holzer Clinic, or the Office of Compliance and Risk Management can provide you with the proper forms to complete.

All injured workers should complete the following forms: Florida Tech Employee Accident/Injury Report, CCMSI False and Fraudulent Claim Warning, CCMSI Authorization for Medical Records and Communication Release, CCMSI Request for Mileage Reimbursement, FICURMA Workers’ Compensation Prescription Information and Workers’ Compensation Witness Report Employee Accident/Injury Forms, when filing. 

It is important that all injured workers complete the workers’ compensation packet including the fraud statement. Benefits might become suspended if said injured workers refuse to provide the requested signature.

The insurance company (CCMSI), upon becoming aware of your injury, will direct you to a healthcare provider for such period as the nature of the injury or the process of recovery may require. Medical care must be authorized by the insurance company.

Per Florida Statute 440.13(2)(a), the law requires that the employer/insurance company provide the appropriate medical care.

No. You must go to an authorized physician provided by your employer or CCMSI.

Yes. Per Florida Statute 440.13(2)(f), you are entitled to one-time change per accident. The request for a change in physician must be in writing and provided to the insurance company (CCMSI). Upon receipt of the request, the insurance company will select and authorize an alternative physician within five days of receipt of the written request. The injured worker or insurance company (CCMSI) may also select a one-time Independent Medical Examination (IME), per accident. Please note, if your accident occurred on or after 10/1/03, the party requesting the IME is responsible for payment.

No, all authorized medical bills should be submitted by the medical provider to CCMSI for payment until you reach maximum medical improvement. Once you reach Maximum Medical Improvement, you will be required to pay $10 copay per visit.

If a prescription is prescribed by your authorized physician, please take the prescription to your pharmacist along with the information from myMatrixx to ensure your prescriptions are billed directly to the insurance company. In rare cases, you may be asked to pay for your medications; if this happens, you will be reimbursed any money you have to advance once receipts are providedto the insurance company.

It is your responsibility to communicate with your supervisor and the Office of Compliance and Risk Management following your appointment. If you are given restrictions or placed out of work anytime during your treatment, please ensure they are communicated to your supervisor and Office of Compliance and Risk Management immediately.

Yes. Time, effort and expense are put into providing your medical care. If you do not follow the doctor’s direction and attend all medical appointments, your case may be terminated for noncompliance and all benefits suspended.

Mail or drop off the medical bill to the Office of Compliance and Risk Management. It will be forwarded to your adjuster. CCMSI will pay all authorized invoices for your claim.

If you, a family member or friend drives you to an authorized appointment, physical therapy, hospital, diagnostic testing or pharmacy, you are entitled to mileage reimbursement at 44.5 cents per mile or current rate. A form is available to document the appropriate mileage.

You should receive the first check within three (3) weeks after reporting your injury to FICURMA/CCMSI and have been off work by an authorized treating physician beyond the waiting period.

All injured workers must report any wages (from all employment) earned to the insurance carrier.

In most cases, benefits are calculated at 66-2/3% of your average weekly wage up to the state max for the year of your accident. If you were injured on or after Oct. 1, 2003, your average weekly wage is calculated using wages earned 13 weeks prior to your injury, not counting the week in which you were injured.

In most cases, your first check will be from the eighth day of disability through the time your authorized treating physician releases you to return to work. Under Florida law, you are not paid for the first seven days of disability, unless you are out more than 21 days.

If you are entitled to benefits, your check will be mailed to your home. Please make sure we have the most up-to-date information regarding your address and phone number.

No, not if you are receiving temporary total or permanent disability benefits. You must be medically able and available to work to qualify for unemployment benefits.

No. It is against the law to fire you because you have filed or attempted to file a workers’ compensation claim.

Contact CCSMI at 407-660-5660. Their mailing address is 2600 Lake Lucien Dr., Suite 225, Maitland, FL 32751.