Workers Compensation

Workers Compensation State of Maryland First Report of Injury

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 submitted via online claims reporting below. The state online reporting form must be completed by the injured worker’s supervisor or next higher level supervisor. Under no circumstances is the state online reporting form to be completed by the injured worker.  If you should have any questions about reporting a claim, please contact the appropriate associate with SISCO or Chesapeake Employers Insurance listed below.  You can present the injured worker with this Frequently Asked Questions brochure.

If the worker is refusing treatment, the injury should be reported and the appropriate refusal of treatment document should be completed.  Please complete the online First Report of Injury and provide a copy of the completed refusal document  to riskmanagement@archbalt.org.  Additionally, this document should be kept on file with the employer 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 complete the online First Report of Injury Form for the correct Claims Administrator.  There are 3 choices below:  AOB Employee, Catholic Charities, Including Non Union NH Employees, and Jenkins Memorial Nursing Home, Inc. ~ St Elizabeth Rehab and Nursing Center Union Employees ONLY.

WC Third Party Administrator Online Reporting

Please click the tab below for instructions

Archdiocese of Baltimore Employees

Archdiocese of Baltimore Employees

Claims Administrator: RCM&D/SISCO

555 Fairmount Ave.
Towson MD  21286
SISCO Claims Adjuster: Allison Boden
aboden@rcmd.com
410-339-5882 
Online Claim Reporting Form: Report an Injury
Incident Report Entry Guide

ALL Catholic Charities Employees, including ALL Nursing Home employees EFFECTIVE 7/31/2022

Catholic Charities
incl. ALL NH
Employees

Claims Administrator: RCM&D/SISCO

555 Fairmount Ave.
Towson MD  21286
SISCO Claims Adjuster: Allison Boden
aboden@rcmd.com
410-339-5882 
Online Claim Form: Report an Injury
Incident Report Entry Guide

NH CLAIMS PRIOR TO 7/31/2022

 

 

Jenkins Memorial NH – St Elizabeth Rehab and Nursing Ctr UNION Employees ONLY
Loss date prior to 7/31/2022

Claims Administrator: Chesapeake Employers Insurance

8722 Loch Raven Boulevard
Towson MD  21286
Contact: FROI@ceiwc.com
Or call Injury Reporting Hotline:
888-410-1400
Report an Injury: www.ceiwc.com