Workers Comp Posting Notice.doc

Workers Comp Posting Notice.doc - COMMONWEALTH OF KENTUCKY...

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COMMONWEALTH OF KENTUCKY WORKERS’ COMPENSATION NOTICE Employees of this business are covered by the Kentucky Workers’ Compensation Act (KRS Chapter 342). Conspicuous posting of this Notice is required by law. Employer Name: _______________________________________________________________________ Address: ______________________________________________________________________________ Workers Compensation Carrier (or third party administrator): ___________________________________________________________ Policy #:________________________, effective _____________ to ______________________________ Address: ______________________________________________________________________________ Telephone: __________________, Contact Person ___________________________________________ EMPLOYEES: IF INJURED – NOTIFY your supervisor IMMEDIATELY; when possible Notice should be in writing. FAILURE to notify your supervisor could result in denial of benefits. OBTAIN MEDICAL CARE. Your employer must pay for ALL NECESSARY MEDICAL CARE to treat a workplace injury. The employee may select the physician or medical facility to render care. If the employer is enrolled in an approved Managed Care Plan employee selection of physicians is LIMITED to the Approved Provider Network,
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