If You Are Injured at Work You will need to follow these steps if you are injured at work: Step 1 Contact your agency and follow its accident reporting procedures. Complete an Accident or Illness Report (Form ADM 4303) and return it to your agency. Form ADM 4303, the Accident or Illness Report, is now available for download. The document is an Acrobat Reader PDF file, and requires Adobe's free Acrobat Reader software to display and print. Follow this link to download, display and print Form ADM 4303, the Accident or Illness Report. The downloaded document (which is about 106K in size) will include an instructions page followed by the two-page form itself. Print pages 2 and 3 of the document, then fill out and submit the form according to the instructions. If you don't have Acrobat Reader installed, follow this link to visit Adobe's Web site and download and install the necessary software before downloading the document. Follow the instructions on Adobe's Web site regarding Acrobat Reader installation. Step 2 Seek medical attention. Your agency has a list of all your Managed Care Organization network providers available to you. Step 3 Your agency and attending physician will complete the rest of the paperwork necessary to file a workers' compensation claim.

SEEKING MEDICAL ATTENTION