Workers’ Compensation

If you are injured while performing work for Pennington County, report the injury to your supervisor immediately.

What to Do

1. Report the Injury
Notify your supervisor and provide details about the injury.

2. Complete the Forms
Complete the First Report of Injury and Medical Authorization Release as required.

3. Seek Medical Care
Tell the medical provider the injury is work-related and provide the Workers’ Compensation Provider Information document.

4. Submit the Forms
Return completed forms as directed by Fire Administration.

Claims Reporting Guidelines

Prompt and complete reporting is important. The First Report of Injury should include accurate employee information, a description of the injury, and the specific injured body part, including right or left when applicable.

Forms & Information

[ First Report of Injury ]
[ Medical Authorization Release ]
[ Workers' Compensation Provider Information]

Claims Administrator

SDML Workers’ Compensation Fund — Claims Associates, Inc.
888-654-6495 | claims@claimsassoc.com