Workers' Compensation Forms
Workers Compensation
MISD Worker's Compensation Forms (Injured Employees Must Contact the Risk Manager within 24 hours of sustaining their injury 432.240.1824):
Employee Worker's Compensation Packet
Worker's Compensation Packet With Campus Instructions
Employee Worker's Compensation Forms (Spanish)
Campus Instructions without Packet
All campuses must submit a First Report of Injury (FROI) within 24 hours of being notified of an employee injury- even if treatment is not needed. If you have any questions, please contact the Risk Manager (432) 240-1824.
MISD Workers' Compensation Doctor: If the employee does not go to NOVA or a doctor in our alliance, they run the risk of being billed directly for their treatment. Employees must make sure they are seeking treatment with a doctor in our alliance when it is related to their workplace injury.
Nova Medical Center
2501 W. Illinois
Midland, TX 79703
432-203-0200
Frequently Asked Questions
- I have restrictions, can I return to work?
- I am out of work due to a work related injury. Am I required to complete a Leave Election Form?
- What Are Temporary Income Benefits?
- What if I elect NOT to use any of my available leave?
- When does the mandatory 7 day waiting period start?
- Can I use my available leave and receive temporary income benefits at the same time?
- Who determines the amount of Temporary Income Benefits I receive?
- I elected to use all my available leave, but my leave is now exhausted. Do I qualify for Temporary Income benefits?
- If I am out due to a work related injury is my job protected?