Workers Compensation is a policy that pays benefits to an employee (or an employee’s family) if the employee suffers a job-related injury (including death) or disease related to work. Any time an employer is aware an employee has sustained an injury in the course of their employment, it is critical that a Maryland First Report of Injury form be completed. The State form must be completed by the injured worker’s supervisor or next higher level supervisor. Under no circumstances is the State form to be completed by the injured worker. Once the form is completed, you are to then either e-mail or fax the First Report of Injury to the designated contact provided below. If you should have any questions about reporting a claim, please contact the appropriate associate with SISCO listed below. You can present the injured worker with this Frequently Asked Questions brochure.
If the worker is refusing treatment, the appropriate refusal of treatment document should be completed and filed in accordance with your record keeping policies.
AOB- WC Refusal of Treatment ACC – WC Refusal of Treatment
For more information about Workers Compensation benefits, contact Tom Alban
Please select your employment category below to send the First Report of Injury Form to the correct Claims Administrator. There are 3 choices below: AoB Employee, Catholic Charities Employees, and Jenkins Memorial Nursing Home, Inc. ~ St Elizabeth Rehab and Nursing Center Employees ONLY.
Archdiocese of Baltimore Employees |
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Claims Administrator: | RCM&D/SISCO 555 Fairmount Ave. Towson MD 21286 |
Email form to: | Allison Boden aboden@rcmd.com 410-339-5882 |
Employer Name and Address: |
Archdiocese of Baltimore 320 Cathedral Street Baltimore MD 21201 |
Catholic Charities Employees |
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Claims Administrator: | RCM&D/SISCO 555 Fairmount Ave. Towson MD 21286 |
Email form to: | Allison Boden aboden@rcmd.com 410-339-5882 |
Employer Name and Address: |
Archdiocese of Baltimore 320 Cathedral Street Baltimore MD 21201 |
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Jenkins Memorial Nursing Home, |
Claims Administrator: | Chesapeake Employers Insurance 8722 Loch Raven Boulevard Towson MD 21286 |
Email form to: | FROI@ceiwc.com Or call Injury Reporting Hotline: 888-410-1400 |
www.ceiwc.com | |
Employer Name and Address: |
Jenkins Memorial Nursing Home, Inc St Elizabeth Rehabilitation and Nursing Center 3320 Benson Avenue Baltimore MD 21227 |