Workers Compensation

The purpose of the Workers' Compensation Act is to provide compensation to an employee for the loss of his or her opportunity to engage in work when the disability is occasioned by an injury suffered from an accident arising out of and during the course of their employment.

Reporting Work-Related Injuries

Injured employees are required to immediately report an accident or illness to AmeriSys at 800-455-2079 to report the workers’ compensation claim. Be prepared to provide the following information.

Employee ID
Full name
Home address
Phone number
Job title
Date of birth
Sex
Social Security Number
Date of accident
Time of accident
Description of the accident
- Being as descriptive as you can, indicate how the accident occurred. Be sure to tell us what the cause of the accident was. Include your direct supervisor or contact person’s name and campus phone number.)
Injury/illness that occurred (Ex. Bruise, strain, cut, scrape, contusion, etc.)
Part of body affected
- Indicate the part of your body affected by the injury. Be sure to specify “left” or “right” when appropriate, and be specific as to the area injured (Ex. “left wrist,” “right knee,” “lower right back”).
Date first reported to your supervisor.
Employer’s address:
1. Florida Polytechnic University, 4700 Research Way, Lakeland FL, 33805-8531, Telephone: 863-583-9050
2. The location number is: 0272
3. Florida Industrial and Phosphate Research Institute location number: 0273

The incident should also be reported to Facilities and Safety Services Office at 863-874-8691.

For additional assistance, contact Human Resources at 863-874-8421 or email DeAnn Doll.