Workers' Compensation

Edwards Risk Management

Our Workers' Compensation Third Party Administrator

Lead Claims Adjuster: Monica Flores monica@edwardsrisk.com

Edwards Claims Administration

1004 Marble Heights Drive

Marble Falls, TX 78654

Phone: 1-800-575-2657

FAX: 1-830-693-2729

http://www.edwardsrisk.com

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Texas Department of Insurance

https://www.tdi.texas.gov/wc/employee/index.html

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Packet of Forms

Employee Workers' Compensation Packet - English

Workers Compensation Package - English.pdf 10.09 MB (Last Modified on September 18, 2019)

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Employee Workers' Compensation Packet - Spanish

Workers Compensation Package - Spanish.pdf 6.43 MB (Last Modified on September 18, 2019)

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Nurse or Supervisor Task List

Nurse or Supervisor Task List.pdf 529.65 KB (Last Modified on October 29, 2020)

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Employee Acknowledgement Log

Employee Acknowledgement Log.pdf 327.88 KB (Last Modified on October 29, 2020)

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Individual Forms (in packet)

Employee Injury Report Form - English

To be completed by Employee and submitted to Campus Nurse or Supervisor if not located on a Campus

Employee Injury Report - English.pdf 417.24 KB (Last Modified on April 1, 2019)

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Employee Injury Report Form - Spanish

Employee Injury Report - Spanish.pdf 432.02 KB (Last Modified on April 1, 2019)

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Employee Rights and Responsibilities - English

To be given to injured employee with the Injury Report

Employee Rights and Responsibilities English.pdf 1.24 MB (Last Modified on April 1, 2019)

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Employee Rights and Responsibilities - Spanish

Employee Rights and Responsibilities Spanish.pdf 1.4 MB (Last Modified on April 1, 2019)

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Health Care Provider Injury Notification Form

Billing information to take to any provider or facility that accepts Workers Compensation

Updated - Health Care Provider Injury Notification Form.pdf 14.55 KB (Last Modified on September 18, 2019)

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Suggested Locations

Suggested Locations for Workers Compensation.pdf 284.43 KB (Last Modified on April 9, 2019)

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CareNow DFW Locations

CareNow DFW Locations.pdf 158.29 KB (Last Modified on October 29, 2020)

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Key Information for Employees

Key Information For Employees.pdf 123.18 KB (Last Modified on April 9, 2019)

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Employee Voluntary Use of Leave Form (ECA-1)

ECA-1 Voluntary Use of Leave Form.pdf 139.07 KB (Last Modified on April 26, 2019)

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Sample Bona Fide Offer

Sample Bona fide Offer.pdf 81.27 KB (Last Modified on April 26, 2019)

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Michelle Benvie
Benefits Supervisor

Phone: 469-219-2015 or ext 12107

Fax: 469-219-2022

Email: mmbenvie@prosper-isd.net

Prosper ISD

Benefits

Workers' Compensation

Edwards Risk Management

Texas Department of Insurance

Packet of Forms

Employee Workers' Compensation Packet - English

Employee Workers' Compensation Packet - Spanish

Nurse or Supervisor Task List

Employee Acknowledgement Log

Individual Forms (in packet)

Employee Injury Report Form - English

Employee Injury Report Form - Spanish

Employee Rights and Responsibilities - English

Employee Rights and Responsibilities - Spanish

Health Care Provider Injury Notification Form

Suggested Locations

CareNow DFW Locations

Key Information for Employees

Employee Voluntary Use of Leave Form (ECA-1)

Sample Bona Fide Offer

Michelle Benvie
Benefits Supervisor

Phone: 469-219-2015 or ext 12107

Fax: 469-219-2022

Email: mmbenvie@prosper-isd.net

Benefits

Workers' Compensation

Edwards Risk Management

Texas Department of Insurance

Packet of Forms

Individual Forms (in packet)

Michelle BenvieBenefits Supervisor

Phone: 469-219-2015 or ext 12107

Fax: 469-219-2022

Email: mmbenvie@prosper-isd.net

Michelle Benvie
Benefits Supervisor