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Steps to Take After an On The Job Injury

City of Memphis – On the Job Injury

City of Memphis On the Job injury program provides City-wide programs and administer payment of medical expenses and lost-time compensation for employees who suffer injury, death, and exposure to blood or other potentially infectious materials or to occupational illness/disease “arising out of” and “in the course and scope of” employees performing their job duties.

This policy covers all employees occupying regular, full-time positions with City of Memphis Government, including those in their initial probationary period with the exception of Police and Fire recruits who are eligible for OJI medical expense benefits only. Temporary employees (temporary, seasonal-temporary, and per-event temporary) are eligible for On-the-Job-Injury (OJI) medical expense benefits only. Only the City Attorney or designee may grant an exception.

The OJI claims for the City of Memphis are classified into four categories: Exposure, a Regular On-the-Job Injury, Occupational Illness/Disease (HHL) and Death. Each claim will be classified as either a Notice Only, Medical Only or Lost Time.

If You are Injured on the Job

For Injury or Exposure:
*Employee must report to supervisor during same shift or no later than 24 hours from incident

For Occupational Disease/Illness:

*Employee must report to supervisor within 30 days from diagnosis

  1. Report your injury to your supervisor immediately. If your injury is urgent or life-threatening, please seek treatment immediately from the nearest hospital.
  2. Your supervisor will complete the necessary injury forms and submit them to Sedgwick. Complete the report by phone or link submission.
  3. When discharged from the emergency facility, the employee must contact the Manager/OSHA Coordinator and Sedgwick to discuss follow-up treatment and return to work instructions.

What should an “employer” do when an employee reports an injury?

Upon the report of a workplace injury, an employer should provide the employee, in writing, a choice of physicians on An Agreement Between Employer/Employee Choice of Physician (Form C-42).

The form must be completed, provided to the employee to allow him/her to designate the authorized treating physician, signed by the employee with a copy given to the employee, and the original kept on file with the employer. The physicians listed should be located in or near the employee’s community of residence.

The employee has the privilege of choosing a physician from the list. The one selected becomes the “authorized treating physician.” The employee is then required to accept treatment from the treating physician and should not seek treatment from any other medical provider unless the treating physician makes a referral.

Employers must also immediately submit all known or reported injuries or illnesses to their insurance carriers unless the employer is qualified and certified as a self-insured employer. Self-insured employers must either report the claim to their Third-Party Administrator (TPA) or internal claims handling program. Reportable workplace injuries or illnesses are those that cause:

An employee to receive medical treatment outside of the employer’s premises; their absence from work, or their retention of a permanent impairment; or, their Death.”

On the Job Injury FAQs

Fire Cancer FAQs

Claims Reporting Quick Reference Guide

Optum First Fill Prescription Card

IOD Attending Physician Form

Choice of Medical Provider Emergency Form

HIPAA Form for Release of Medical Information

St. Francis Hospital Authorization to Release Medical Information

Baptist Medical Group Authorization to Release PHI

Sample Intake Form

OJI Appeal Form

Declination of OJI and Medical Treatment

File an Injury Report

OJI Full Policy

For assistance regarding network providers, please contact the OJI Coordinator by calling 901-636-6459

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