Worker's Compensation Insurance Claim


How to Process Your Worker's Compensation Insurance Claim


Click HERE to print the packet explained in the directions below. The packet includes the Accident Report, Physician's Initial Report, and the Activity Prescription form (APF).

The following are steps needed to insure your claim is processed in a timely manner.

  1. Immediately report your injury to your supervisor and pick up an Injury Packet from the Human Resources and complete the required drug test.

  2. Seek medical attention. IMPORTANT: Your employer/Tribal First reserves the right to direct your care to a provider of their choice. Please check with your employer, before seeking medical attention, to verify whether or not a provider has already been selected.

  3. Have the attending physician complete the Physician's Initial Report included in this packet. You may leave this form with your physician, and he/she will forward it to the insurance company listed on the form. Your attending physician should also complete the Activity Prescription Form. This form needs to be returned to Human Resources to the attention of Tammy Walker. This form will be forwarded to Tribal First with your Accident Report.

  4. Complete the upper portion of the Accident Report included in this packet. This should be completed within two days of the injury. Return the completed form to the Human Resources. Human Resources will complete the bottom portion of the Accident Report and forward to Tribal First.
  5. As soon as Tribal First receives your completed Accident Report, your claim will be processed and a claim number assigned. If Tribal First does not receive a completed form, the time loss or medical benefits cannot be provided.


Click HERE to print Workers' Compensation Insurance Claim packet